Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an announced visit with applicant Nelson Arguelles. The purpose of the visit was to conduct the Pre-Licensing visit.

An application was submitted to CCLD on 6/2/2021, for an Initial License of a Adult Residential Facility for . The requested capacity of 4 clients, (4) ambulatory, (0) non-ambulatory and (0) may be bedridden.

The facility is 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, (3) resident rooms, (2) bathrooms; each bathroom with shower, toilet and washbasin. A back yard with shaded area and seating for resident use. An attached garage inaccessible to clients for storage, a 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. Client Rooms: Bedroom #1 for (2) ambulatory residents, Bedrooms #2 and #3 are for (1) ambulatory client each. All bedrooms are equipped with required overhead lighting, chair, night stand, lamp in addition to overhead lighting, large drawer, and closet space. Bathrooms: Bathroom #1 and #2 all have a working toilet, wash basins, showers, grab bars and nonskid mats. Linens & Hygiene Supplies: Required linen/supplies which include, pillowcase, fitted sheet, blankets, bedspreads. Mattress pads were observed. Emergency Phone Numbers, Exit Plan & Menu: Facility has a working phone landline. There is (2) cordless phones for residents use. Fire Extinguisher 1 and 2 fully charged and up to date. Exit plan posted. Food Menu observed. Food Service: All food and adequate utensils such as, dishes, cups, bowls and plates observed. Knives, cutlery and other sharps inaccessible to residents will be kept in a locked cabinet.