Facility Evaluation Report

On 6/03/2025 at approximately 9:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the Administrator Anna Liza Calderon-Macias and stated the reason for their visit.

LPA asked for the census and Staff/Client Roster. LPA conducted a physical plant tour at approximately 11:00 AM and the following was noted:

The facility is a single unit building with six (6) bedrooms and two (2) bathrooms currently occupying four (4) clients. There are two (2) designated staff rooms and one (1) staff bathroom. The facility has an approved fire clearance for four (4) ambulatory clients. The facility is vendor through North Los Angeles Regional Center (NLARC) and is being operated at a Level II Adult Residential Home. Sign in sheets, hand sanitizers, gloves and masks are available immediately upon entrance.

Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 74°F. LPA observed a fire extinguisher to be located in the kitchen and dated 10/03/2024. LPA observed required postings such as See/Say Something, Facility License, and Personal Rights located alongside the entrance and hallway’s passageway. A working telephone was observed.

Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Kitchen appliances were observed to be working and in proper condition. The knives/sharps were observed to be kept within a locked box inside of a locked filing cabinet located near the entrance. Laundry Room: The laundry appliances were observed to be located aside the kitchen and the backyard. The laundry appliances were observed to be working and in proper condition. (continued on LIC 809-C)