Facility Evaluation Report

Licensing Program Analyst (LPA) Evelin Rios conducted a Pre-Licensing Inspection with the applicant representative / administrator, Phil Zhou and administrator designee Kazeem Abass. The applicant is "ASHTON HOME LLC ". This is a Change in Ownership "CHOW" application. A fire clearance was approved on 10/23/24 for six (6) non-ambulatory residents, one (1) of which may be bedridden in Room #3. The facility has a total of six (6) bedrooms and three (3) bathrooms.

A tour of the physical plant was initiated at approximately 9:15 AM and the following was observed:

KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. There was an adequate supply of perishable and nonperishable food. Knives were observed locked in a kitchen cabinet. Cleaning supplies and other toxins were observed locked under the kitchen sink cabinet.

BEDROOMS: There are five (5) bedrooms designated for residents use; four (4) private and one (1) shared. The bedrooms are furnished with beds, night stand, chairs, dressers, bedding and appropriate linens. The bedrooms have sufficient lighting and storage.

BATHROOMS: The facility has three (3) bathrooms; one (1) is located in the shared bedroom. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at 118.4°F, within regulation.

LAUNDRY ROOM: The laundry room leads to the garage and is maintained locked. Laundry detergents and other cleaning agents were locked in a cabinets inside the laundry room. The garage was observed to be locked during visit. The facility keeps a second refrigerator and a freezer. (Continued on LIC 809-C)