Facility Evaluation Report

On 02/14/24, at 09:25am, Licensing Program Analyst (LPA), Gina Saucedo, conducted an announced visit to the facility for purpose of a pre-licensing evaluation.

An application was submitted to Community Care Licensing Division-CCLD on 05/11/2023, Initial license for a Residential Care Facility for the Elderly, 60 years and older. The requested capacity is for one (1) bedridden, four (4) non-ambulatory and one (1) ambulatory, total of up to six (6) residents.

Facility is a single-story home. Today's site visit consisted of LPA touring the physical plant at 10:05 AM inside and outside and observed the following:

There is a bedroom designated for staff next to the kitchen on your left-hand side.

There is a total of four (4) bedrooms for resident use. BEDROOMS APPROVED FOR ONLY AMBULATORY SHALL NOT BE USED FOR NON-AMB, PER 85087. There shall be no more than two clients per bedroom. Bedrooms #1 (one) and bedroom #2 (two) is for non-ambulatory occupancy and will be shared occupancy, bedroom number #3 (three) is for bedridden occupancy only and has a private bathroom which is cleared by the Fire Safety Inspection Request. Bedroom number #4 (four) will be a single, ambulatory bedroom. All the bedrooms have proper bedding, chairs, night stands, lamps in addition to overhead lighting.