Facility Evaluation Report

On Monday, July 17, 2023, at 8:30AM, Licensing Program Analyst (LPA) Mario Leon initiated an announced Pre-Licensing Visit to the above mentioned facility.

An application was submitted to the Department of Social Service, Community Care Licensing Division (CCLD) dated 05/02/2023 for an initial application for a Residential Care Facility for the Elderly (RCFE) aged 60+. The requested capacity is six (6) non-ambulatory. The Fire Safety Inspection Request is granted and approved for 5 non-ambulatory and 1 ambulatory resident. LPA Leon verified both an approved Mitigation Plan Report and Infection Control Plan.

Structure: The facility is a single-story-family home located in a residential neighborhood. The facility has a living room, kitchen, dining area, 5 bedrooms, 3 bathrooms, 2 offices, shaded patio area, indoor/outdoor activity areas and an attached garage. The front and back yard landscape is in good condition at the time of the visit. Bedrooms: Bedrooms 1-5 are designated as client bedrooms and office 1 will be designated as staff sleeping room. Bedroom 4 is designated as a shared room. The bedrooms have a twin-sized bed, chair, night stand with storage, lamps, and closet space available. Bathrooms: Bathrooms 1-2 have a working toilet, grab frame surrounding toilet, washbasin, and shower with grab bars, anti-slip tape strips in the shower, and covered trash cans. Bathroom 3 is designated as staff restroom.