Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced annual inspection. LPA met with Licensee Jungea Chun and explained the reason for the visit. The facility is licensed for 4 adults, ages 18 through 59, of which 2 may be non-ambulatory. Rooms #2 and #3 are approved for non-ambulatory. There are currently no clients residing at the facility. Licensee discussed with LPA that the intention is to change the facility type from an Adult Residential Facility to a Residential Care Facility for the Elderly. Licensee does not intend to take in any clients or residents until they finalize the change with the department. LPA also discussed the licensing fees owed with the licensee.

The facility is a one story house consisting of 4 client bedrooms, 2 bathrooms, living room, dining area, kitchen, office area, and detached garage. The laundry area is located outside in the backyard. The spacious back yard is well maintained and has a shaded area and sitting area for client to use. There are no pool or bodies of water on the premises. Each clients bedroom has the required furniture, lighting, and closet space. Knives and cleaning products are locked in the kitchen cabinets. Smoke and carbon monoxide combo detectors are located in each room. The hot water temperature was measured between the required range of 105-120 degrees F. The food supply is adequate. There is a centrally stored medication in the facility; however, no medications were reviewed since there are no clients. Area for staff and client files to be stored was observed. (1) Staff file was reviewed. Plan of Operation was reviewed.

No deficiencies were issued. However, LPA provided technical violations during the visit. An exit interview was conducted and a copy of the report was given to the licensee.