Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway conducted an announced Pre-Licensing Inspection to the above listed facility. Upon arrival LPA met with Licensee Representative Justin Levi and Administrator Alexis Sias. Entrance interview conducted.

An application to operate an Adult Residential Facility (ARF) was received by Community Care Licensing (CCL) on 01/23/2023. A Fire Clearance was approved for a maximum capacity of four (4) non-ambulatory clients on 10/17/2023. The proposed physical plant is a one (1) story single family dwelling located in a residential neighborhood of Lake Balboa, CA. This facility will be housing clients from Regional Center, and it will be classified as a Level 4I housing. Regional Center application is in process and not approved at the time of the visit. This facility doesn’t have a staff room, facility will provide 24/7 care.

At 10:25 am a tour of the physical plant was conducted and the following observed:

BEDROOMS: There are four (4) bedrooms, all of which are designated for client use. All bedrooms are for single occupancy. All bedrooms were equipped and supplied with appropriate furniture, bedding, and linens. No client bedroom will be used as a public or general passageway to another room, bath, or toilet. There were no visible hazards or discrepancies observed. Auditorial signal was observed in each door around the facility.