Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an announced visit with applicants Yessica Hernandez & Edgar Hernandez. The purpose of the visit was to conduct the Pre-Licensing visit.

An application was submitted to CCLD on 1/7/2022, for Intial License of an Adult Residential Facility. The requested capacity of 4 clients, (4) ambulatory, (0) non-ambulatory of which (0) may be bedridden.

The facility is a single story home located in a residential area and contains the following: family room, dining room, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, locked storage cabinet for sharps, (2) client rooms, (1) Staff room with attached bathroom. (1) bathroom for client use; bathrooms with shower, toilet and washbasin. A back yard with shaded area and seating for resident use. An attached garage inaccessible to clients for storage. A washer and dryer. The residence is equipped with central air and heating.

Accommodations : Adequate accommodations observed throughout facility. Lighting: Sufficient Lighting throughout. Hallway and Doorways: Free and clean of obstruction and debris. Resident Rooms: Bedrooms #1-#2 are for (2) ambulatory clients each. All bedrooms are equipped with: overhead lighting, chair, night stand, lamp in addition to overhead lighting, large drawer, and closet space. Bathrooms: Bathroom #1 and #2 have a working toilet, wash basin, shower, and nonskid mats. Safety bars were observed in the shower and around the toilet. Linens & Hygiene Supplies: Required linen/supplies which include, pillowcase, fitted sheet, blankets, bedspreads. Mattress pads were observed.