Facility Evaluation Report

On 3/1/2023, Licensing Program Analyst (LPA) Melissa Ruiz arrived at the facility to conduct an announced Pre-licensing inspection. Upon arrival LPA met with applicant Chryshel Dela Cruz. The facility will be licensed as aResidential Care Facility for the Elderly. Facility is a single-story house with four (4) bedrooms and two (2) bathrooms. Facility has been approved for a capacity for six (6) clients.

The physical plant was toured inside and out at 10: 45 a.m. and LPA observed the following:

Common Area: LPA observed the living room and furniture to be clean and in good repair. LPA observed the dining area to be clean and in good repair. The facility maintains a comfortable temperature at 73 degrees Fahrenheit. The air conditioner is operational. No firearms observed or will be maintained on the premises. The smoke alarm and carbon monoxide detector are dual functioning and hard wired throughout the facility. There are various fire extinguishers which were observed to be fully charged. Facility maintains an operational telephone.

Kitchen Area: LPA observed the kitchen area to be in good repair and sanitary. A start up amount of perishable and non-perishable foods were observed. A cabinet with a lock will be used to keep sharps locked and inaccessible to residents in care. Medication will also be centrally stored and locked in a kitchen cabinet. Trash containers have tight-fitting lids.

Bedrooms: Facility has four (4) bedrooms, three (3) of which will be for residents and one (1) for staff. All bedrooms were toured and were observed with the appropriate furniture and bedding and sufficient lighting was observed. (cont. on LIC809-C)