Facility Evaluation Report

At 10:10 am Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit with the licensee and administrator. Identification of the Licensee and administrator was verified by photo ID.The facility has a capacity of six (6). Application received for 1 bedridden and (5) Non-ambulatory residents.

Purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following:

The common areas (kitchen, living room, and dining areas) were appropriately furnished, and lighting was adequate. The facility has a variety of adequate perishable and non-perishable food supply. Appliances in the kitchen appeared to be functional. The living room has a television and comfortable furniture. Games and activities for residents stored in coffee table.

There is one (1) fire extinguishers: one (1) is located in garage attached to kitchen/dining room wall and observed to be fully charged with receipt Dec 2023. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at time of visit.

An emergency exit plan/sketch is posted near each entrance/exit wall with other posting requirements.

There are two (2) bathrooms in the facility. The Hot water was tested for resident bathroom and measured 115.9 and 117.1 °F. Bathrooms has trash cans with lids and bathroom has functional grab bars.