Facility Evaluation Report

On 9/25/2024, Licensing Program Analyst (LPA) Evelin Rios conducted an announced Pre-Licensing visit to this facility and met with Chary Hallon the Assistant Administrator. Administrator Asilia Wauls met LPA shortly after. This is a change of location application and fire clearance was approved on 08/21/2024. Fire clearance is for four (4) ambulatory clients. The administrator stated the four (4) clients are currently residing at 43139 FENNER AVE , LANCASTER , CA 93536, facility # 197609034 and will be moving to this location. The Administrator stated the second living room, dining room, and bedroom furniture will be brought in from the licensed facility prior to residents moving into the home.

LPA confirmed Asilia Wauls and Chary Hallon both participated in Component III with LPA Spaeth on 03/8/2024. Today’s site visit consisted of LPA touring the physical plant inside and outside from 9:30 a.m. until 11:00 a.m. LPA Rios observed the following:

Common Areas: These include two dining areas and two living areas. These areas are spacious and currently one of two living areas has couches that sit the capacity of the facility. One of two dining areas has a large dining table with chairs that sit the capacity of the facility. The rest of the furniture will be moved from the facility #197609034. Cleaning products will be stored in an entry closet that is able to lock. LPA observed two facility telephones in the living areas accessible to clients. Telephone was operational.

Kitchen: The facility contained a seven day supply of non-perishable food. LPA observed a fire extinguisher by the kitchen with a service date 07/30/2024. Appliances such as the gas stove, refrigerator, microwave and dishwasher were observed operational. The medication, first aid, knives, sharps, resident and staff files will be stored in the a kitchen closet that is able to lock and will be inaccessible to clients.