Facility Evaluation Report

On 8/31/2023, Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced Pre-Licensing visit to this facility and met with the Licensee. This is a new application and a fire clearance dated 08/08/2023 was received for six (6) non-ambulatory residents. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6.

Component III was conducted with the applicant from 10:20 am until 11:00 am

Today’s site visit consisted of LPA touring the physical plant inside and outside from 11:00 am until 11:45 am. LPA Spaeth observed the following:

Living/Dining Room – LPA observed the living room and dining room are combined. The living room area contained two couches, chairs, and a television. The dining room contained a dining room table with chairs.

Kitchen - The facility contained a seven day supply of non-perishable food and a two day supply of perishable foods. A locked kitchen cabinet underneath the kitchen sink contained the cleaning supplies. There is a locked drawer for knives. A fire extinguisher is also located in the kitchen. Appliances in the kitchen appeared to be functional.

Backyard - The backyard contained comfortable seating for residents. The side gate leading from the backyard to the front yard was not locked. There are two sheds located in the backyard. One shed was empty and the other shed contained additional folding chairs.