Facility Evaluation Report

Licensing Program Analysts (LPA) Jose Villalobos conducted an announced visit with Applicant Erdenetuya Ulziibaatar. The purpose of the visit was to conduct the Pre-Licensing visit.

An application was submitted to CCLD on 4/13/2022, for an Initial License of a Residential Care Facility for the Elderly for ages 60 years and older. The requested capacity of 6 residents, (0) ambulatory, (5) non-ambulatory and (1) may be bedridden.

The facility is part of a single story home located in a residential area and contains the following: living room, dining room, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, locked storage cabinet for medications and sharps, (4) resident rooms, (1) bathrooms for residents and (1) bathroom for staff; bathrooms with shower, toilet and washbasin. A back yard with shaded area and seating for resident use, area for washer and dryer. The residence is equipped with central air and heating.

Accommodations : Adequate accommodations observed throughout facility. Lighting: Sufficient Lighting throughout. Hallway and Doorways: Free and clean of obstruction and debris. Resident Rooms: Bedrooms #1 is cleared for (1) bedridden resident. Bedroom #2 is for (1) non-ambulatory residents. Bedroom #3 and #4 are for (2) non ambulatory residents. All bedrooms are equipped with: overhead lighting, chair, night stand, lamp in addition to overhead lighting, large drawer, and closet space. Bathrooms: Bathroom #1 and #2 have a working toilet, wash basin, shower, grab bars and nonskid mats.