Facility Evaluation Report

On 08/12/2024 at 09:50 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced Pre-Licensing Inspection with Licensee Anthony Powell. An application to operate an Adult Residential Facility (ARF) was received by Community Care Licensing (CCL) on 01/05/2024. A fire clearance was approved on 6/26/2024, for one (1) non-ambulatory client and three (3) ambulatory clients for a total capacity of four (4). Bedroom 1-3 are designated for ambulatory clients and bedroom 4 is for a non-ambulatory client. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6.

The Component III presentation was conducted from 10:15 am until 11:05 am with Licensee.

A tour of the physical plant was initiated at approximately 11:10 am and the following was observed:

KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of two (2) days perishable and seven (7) days of nonperishable food and dining ware to accommodate a maximum capacity of four (4). Knives will be locked under the kitchen sink within a locked box. Medication will be locked in a kitchen cabinet. The facility has one fire extinguisher that was fully charged on 07/05/2024. It is in the kitchen hallway. There is a first aid kit located in a kitchen cabinet and is equipped with the necessary supplies.

COMMON AREAS: These included the living room and dining room areas, which were equipped with living room furniture, a television, table, and chairs. The dining room table is large enough to accommodate up to four (4) clients. There were no visible immediate hazards. The smoke alarms are hard wired and inter-connected and are functional. The carbon monoxide detector is functional. The facility temperature was at a comfortable 70 degrees Fahrenheit.