Facility Evaluation Report

Licensing Program Analysts (LPAs) Luis De Leon and Nune Margaryan conducted an announced visit to the facility for the purpose of pre-licensing evaluation. The CARE Tool was using during initial inspection. Present for the pre-licensing inspection were Sharon Han (licensee), Huendy Mora (Administrator), Lee Strollo (District Manager) and Jessica Rodriguez (Assistant Administrator). An application was submitted to CCLD on 9/25/24, for initial license for Adult Residential Facility- for Enhanced Behavioral Supports Home. The new license request is a result of a change of ownership application. The facility has an approved fire clearance for three (3) non-ambulatory clients and facility approved for total capacity of three (3).

This is a one-story home located in a residential neighborhood area which will be licensed as an Adult Residential Facility for Enhanced Behavioral Supports Home. The facility was toured. The following was observed:

Three (3) client bedrooms, two (2) bathrooms, living room, dining area, kitchen, office room, activity/therapy room, and an attached garage. Client bedrooms were checked. Each bedroom is equipped with the proper furnishings. Bedrooms also have sufficient closet space. Bathrooms are clean and have the required hygiene items.

Laundry room was located on the end of the kitchen.

The front and backyard are well maintained and there are no pools or large bodies of water.

There is a shaded seating area for the clients located in the backyard.

Hallways and exits are free of obstruction.

There is only one entrance being utilized at the facility.

All required posters were posted at the entrance.

There is sufficient perishable and non-perishable food.

See LIC-809C for continuation of report .