Facility Evaluation Report

On 11.29.2023 Licensing Program Analyst (LPA) Leslie Ngo-Castaneda arrived at facility at 9:28am to conduct a pre-licensing inspection with the assistant-administrator. Lora May Pana (assistant- administrator) was greeted upon entering the facility. An application to operate a Adult Residential Facility for (ARF) was received by Community Care Licensing (CCL) on 10.27.2023. A fire clearance was approved on 6.4.2024 for four (4) bedridden, for a total capacity of four (4). The smoke alarms and carbon monoxide detector are hard wired and inter-connected. The facility has one new fire extinguishers that was purchased on 7.8.2024. One fire extinguisher is located in the kitchen in between the laundry and dining table.

A tour of the physical plant was initiated at approximately 9:42 AM and the following was observed:

KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave oven, and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). LPA inspected the kitchen and observed gas stove and refrigerator to be clean and working. Knives and sharps are stored in a locked cabinet under the sink. Cleaning agents are also stored under the sink with a locking mechanism.

BEDROOMS: There are four (4) bedrooms designated for client use in the hallway. Bedroom #1, room #2, room #3 and room #4 are cleared to be private rooms. The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding, and linen. The bedrooms have sufficient lighting and closet space. The linens were stored in the storage space in each residents bedrooms.