Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez made an announced visit and met with House Manager Melvin Alvarez-Mendoza and Licensee Sean Walters, to conduct a Pre-Licensing evaluation.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: An application was submitted to Community Care Licensing Department (CCLD) on for an initial application of a Adult Residential Facility (ARF) to serve developmentally disabled adults ages 18 - 59 with. Structure: Facility is a single-story home located in a residential area consisting of four (4) bedrooms, two (2) bathrooms, kitchen, dining room, living room, family room, garage, and a backyard with seating and shade. Operational Requirements: The facility provided proof of liability insurance during today's visit. Auditory devices are in working condition. Bedroom Clients: Bedrooms are equipped with a bed, night stand, chair, lamp, dresser, trash bins, and overhead lighting. Bathrooms: One (1) full bath equipped with working toilet, wash basins, bathtub/shower and One (1) full bath equipped with working toilet, wash basins, walk in shower. Linens & Hygiene Supplies: All beds had the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linens is stored in linen closets. Emergency Phone Numbers, Exit Plan: Emergency numbers and Exit plans are posted and readily available for review. Three (3) fully charged fire extinguishers was observed. Facility has a land line telephone. Food Service: Dishes, cups, and flatware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery, and other sharp kitchen utensils were observed locked and inaccessible. Adequate food supply is stored in the kitchen and consists of the following: 2-day perishables, and 7-day non-perishables. Emergency water supply was observed.