Facility Evaluation Report

On 5/4/23 at 9:10 AM Licensing Program Manager (LPM)/ Eva Alvarez and Licensing Program Analysts (LPA)/Alfonso Iniguez conducted a pre-licensing evaluation Change of Ownership (CHOW) for an RCFE (Adult Residential Care Facility for the Elderly) facility type. Today’s pre-licensing evaluation was conducted with Rosemarie Famisan/Administrator/Licensee.

The licensee has applied for a license to serve (6) 60 years and over. The fire clearance is approved for (3) non-ambulatory and (1) bedridden. Approved hospice waiver for (6) Hospice Residents.

LPM and LPA toured facility Kitchen, Dining Room, Living Room, (4) Bedrooms, (2) Bathrooms, Garage, Back Yard, and Patio with shaded area. LPM and LPA observed sufficient storage areas for kitchen supplies, linens, medications (secured) and chemicals (secured).

LPM and LPA observed the following during this visit:

There is a locked centralized storage area for Resident medications.

LPM and LPA observed the facility is clean, sanitary, and in good repair. Protective devices are in place. Indoor and outdoor passageways, stairways, open porches, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair. Facility temperature is between 68°F. degrees and 85°F. degrees. Open porch, and areas of potential hazard are well-lit and equipped with sturdy hand railings. Carbon monoxide/Smoke detectors operate properly.