Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan conducted an announced Pre licensing visit on this date. LPA met with Licensee representative Gershom Benitez. A Fire Clearance dated 04/29/24 is approved for four (4) ambulatory clients. This will be a North Los Angeles Regional Center vendored facility Level II.

LPA toured the facility inside and out at 12:50 PM. Dual smoke and carbon monoxide alarms are hard wired and interconnected. The facility has four (4) client bedrooms. Each room is furnished with beds, lights, night stands and seating. One additional (1) bedroom is designated for staff use. Sufficient closet space was observed for each room. Medication will be stored in a cabinet in the kitchen. Medication storage is equipped with a lock to ensure medications will not be inaccessible to clients. Storage for client and staff records are also observed to be locked in the cabinet in the bedroom hallway. There is a working telephone on the premises.

Common areas were appropriately furnished and lighting was adequate. LPA observed a fully charged fire extinguisher in the dining room bought in 07/29/24. A complete first aid kit was observed in the kitchen. The water temperature in client restrooms was measured at a range of 106.7°F to 118.9°F. Appliances in the kitchen were clean and all appeared functional.

The garage will be used as a Laundry area, new washer and dryer are properly installed. Laundry detergent and other cleaning supplies are stored in a locked cabinet in the garage. The garage is also being used as Emergency food and PPE storage.