Facility Evaluation Report

On 6/05/2024, Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced pre-Licensing visit to this facility and met with the Licensee/Administrator. This is a new application and a fire clearance dated 01/16/2024 was received for four (4) 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. The component III orientation was conducted with the applicant from 9:40 am until 10:15 am.

Today’s site visit consisted of LPA touring the physical plant inside and outside from 10:15 am until 10:55 am. LPA Spaeth observed the following:

Dining Room – LPA Spaeth observed a dining room table and chairs in the room. The fire extinguisher is located near the kitchen and was operable.

Kitchen/Family Room - The facility contained a seven day supply of non-perishable food and a two day supply of perishable foods. Appliances in the kitchen appeared to be functional. The first aid kit, cleaning solutions, and knives were safely locked underneath the kitchen sink. The client medication containers were also safely locked in a kitchen cabinet. The family room contained comfortable seating, games, and a television

Backyard - The backyard contained a shaded area and comfortable seating so that residents may enjoy outside activities. The side gate leading from the backyard to the front yard was not locked.