Facility Evaluation Report

Licensing Program Analysts (LPAs) Christine Wong, Benette Pena, Ashley Calderon, Valeria Maldonado conducted an announced visit to the facility for purpose of a pre-licensing evaluation. An application was submitted to CCLD on 12/17/21, for initial license for a Residential Care Facility for the Elderly, to serve 60 years and older. The requested capacity is for 5 ambulatory, of which 1 maybe bedridden and 1 maybe non-ambulatory in bedroom#3.

Facility is a 3 bedrooms, 2 bathrooms, single story house with a detached two cars garage. The facility consists of sitting room, dining area, living room, kitchen. The home has a gas fire place in the living room with a metal screen cover, and is inaccessible to residents. There is a large back yard with shaded area with tables and chairs for residents to use. The residents bedrooms are spacious and will easily accommodate the residents furnishings. . The exit and passageways are free from obstructions. The front, back and side areas of free of hazards and debris.

There shall be no more than two residents per bedroom. Bedrooms#3 is for non-ambulatory residents. Bedroom #1 and #3 have two beds, two chairs, two night stands, closet. Bedroom#2 has one bed, one chair, one night stand and closet.