Facility Evaluation Report

Licensing Program Analysts (LPA), Linda Almaraz conducted a visit to the above facility for a PRE-LICENSING evaluation. LPA met with Licensee's, Apolonio Santos Jr. and Rowena Santos. LPA did a walk through of the facility with the assistance of both Mr and Mrs. Santos.

Facility is a (4) bedroom, (1) staff bedroom, (2) bathroom, single-story house. The home has a living room, dining room, large kitchen, and laundry room. There is a medium size back yard with shade. The residents bedrooms are spacious and will easily accommodate the resident's furnishings. The facility also has a garage that will not be accessible to residents.

All exits doors are equipped with a sensor type alarm systems which alerts staff.

Bedrooms are approved for (4) non-ambulatory residents and (2) bedridden residents in Room #3. All bedrooms have the required bed(s), chair(s), night stand(s), and lamp(s).

Laundry room has a washer and dryer. Laundry supply is secured and locked separately.

All bathrooms have a working toilet, wash basin, and shower. There is two (2) bathrooms in the facility. Water temperature was within required range of 105-120 degrees F. (Continued on an LIC-809-C)