Facility Evaluation Report

At 9:25 am Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit with administrator. Identification of the Applicant/administrator was verified by CA driver’s license.

The facility has a capacity of four (4). Application received for 4-bedridden clients.

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 living room has a television and comfortable furniture.

The facility has a variety of adequate perishable and non-perishable food supply. Appliances in the kitchen appeared to be functional. The sharps are stored and locked in drawer in kitchen and under kitchen sink. Kitchen cleaning supplies, laundry detergents, and other toxins are stored and locked under the kitchen sink.

Laundry room located in garage. Washer and dryer observed to be in good repair.

There is one (1) fire extinguisher: located in kitchen area attached to wall. Fire extinguisher observed to be fully charged. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at approximately 10:05 am.