Facility Evaluation Report

On 7/5/2022 Licensing Program Analyst (LPA’s) Antonia Alvizar and Stephanie Cifuentes conducted an announced visit to the facility for purpose of a pre-licensing evaluation. Today’s pre-licensing evaluation was conducted with applicant Mart Pamintuan. On 2/28/2022 an initial application was received for a Residential Care Facility for the Elderly. The requested capacity is for 6 residents facility has a fire clearance for 6 non-ambulatory residents only.

Structure: Facility is a 6-resident bedroom, 3- bathrooms, 1 one-story house with a 1 car attached garage and an outdoor shaded area in the back yard. The resident bedrooms are spacious and easily accommodate the resident's furnishings. There is a shaded back patio which contains a table and 6 chairs. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility.

Bedrooms Residents: All six bedrooms have one bed, one chair, one nightstand, overhead lighting, closets, and dressers. All drawers comply with the requirement of 8 cubic feet of space. There was one designated staff bedroom observed.

Bathrooms: All 3 bathrooms have working toilets, wash basins and shower/bathtub. There are grab rails next to both toilets and showers. The tile in bathrooms are made from noon skid material. LPA observed adequate lighting in hallway leading to bathrooms via nightlights.