Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Tan met with Ariana Madrigal for a Required One (1) Year visit. Ms. Madrigal called the Administrator Cory Mitchell and explained the reason for the visit. Mr. Mitchell designated Ms. Madrigal to sign the report. A tour of the physical plant was conducted at around 9:00 AM and the following was noted:

There is one entrance being utilized at the facility. The facility is a two (2) storey house and has a total of four (4) bedrooms and three (3) bathrooms. Three (3) rooms are located upstairs and one (1) downstairs. One (1) bedroom is converted into an office for the staff. The facility is fire cleared for six (6) ambulatory residents. The facility is currently occupying four (5) residents.

Kitchen is sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked in the filing cabinet in the office adjacent to the kitchen and inaccessible to residents.

The living and dining room are neat, clean and in good repair. The facility maintains a comfortable temperature at 72°F. The smoke and carbon monoxide detectors are hardwired, interconnected, tested and observed to be operational. Fire extinguisher is located near the main entrance door and observed to be fully charged and last inspected 01/15/2025. The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. (continued on LIC 809-C)