Facility Evaluation Report

On 03/05/2025 the Licensing Program Manager Ulysses Coronel and Licensing Program Analyst Jose Anguiano conducted an announced visit to the facility for purpose of a pre-licensing evaluation. The pre-licensing evaluation was conducted with Sophesias Johnson.

On 05/22/2024 an application was submitted to CCLD, for Adult Residential Facility. The requested capacity is for 6 of which 0 may be non-ambulatory and 0 may be bedridden.The facility is a 3-bedroom,1 bathroom, 1 story house.

CCLD staff conducted a review of the Physical Plant, Bedrooms, Bathrooms, Supplies, Food Service, Medications, Records, Administration, Activities, Pe-Licensing Checklist and Component III Orientation.

There is a locked centralized storage area for client medications.

Facility is clean, sanitary, and in good repair. Protective devices are in place to include non-slip material in bathroom. Indoor and outdoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions. Facility temperature is between 68 degrees and 85 degrees. Open-faced heaters are inaccessible to clients. Carbon monoxide detectors operate properly.

Halls, stairways, unfinished attics or basements, garages, storage areas, and sheds, or similar detached buildings are not being used as client bedrooms. Client bedrooms are large enough to allow for easy passage and to accommodate furniture. No client bedroom is a passageway to another room, bath or toilet. There is a bed for each client with a mattress, mattress pad, bedsprings, and pillow(s) which are clean and in good repair. Mattresses and pillows are flame-retardant.