Facility Evaluation Report

Licensing Program Analysts (LPAs) Ya-Ting Yang and Jose Villalobos conducted an announced pre-licensing visit. LPAs met with the Applicants Cindy Perera and Veronica Perera for the purpose of conducting a pre-licensing inspection. Licensee / Perera Home Care, INC has submitted an application to operate an Adult Residential Facility for a capacity of four (4) residents, ages 15 to 59. The facility has an approved fire clearance for four ambulatory residents . Fire clearance was granted on 8/4/22 . The new application is being processed as an initial license . There are currently no (0) clients living at the facility.

LPAs toured the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility is located in a residential neighborhood. The facility consists of a main floor. A tour of the main floor includes four (4) client bedrooms, two (2) common bathrooms, a living room/activity room, kitchen, dining area, laundry area, medication area, attached garage, no private bathrooms observed.

LPAs observed a fully equipped living room and a dining area with sufficient dining capacity. The kitchen was observed for the ability to prepare and serve food. Appliances in the kitchen were clean and all functional. The supply of dishes/cups was adequate. During today's visit, LPAs observed an appropriate food supply of two (2) days of perishables, seven (7) days of non-perishables, and additional food and water for emergency use in the cabinet. Client bedrooms were inspected for linens and personal accommodations for safety, privacy, and comfort. Client bedrooms were equipped with a bed, chair, night stand, adequate lighting and ample closet/storage space for each client. The bathroom s were clean, operational with non-skid mats, and equipped with paper towels.