Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted this visit to conduct the pre-licensing. LPAs met with Applicant, Diana Rojas.

The facility is to serve (4) ambulatory individuals age 18 through 59 years old. This home consists of (3) bedrooms, (2) bathrooms, living room, kitchen and dining area. Component III was also completed during this visit.

Carbon monoxide detector was tested and operable. Located in the living room

Fire extinguisher located in the entrance/kitchen. Located near the front door and in the living room.

Cleaning solutions and sharps are locked.

Mattresses and bedsprings are in good repair.

Bedrooms are large enough to allow for easy passage between and comfortable for usage of beds and other required items of furniture.

Clients have the appropriate furniture (one chair, night stand, adequate lighting for each client adequate closet and drawer space).

There ar e enough bath towels, hand towels and wash cloths for all clients.

Sufficient amount of personal hygiene supplies are available for clients.

Sufficient amount of linens available to permit weekly changing to ensure use of clean linens at all times by clients.

Facility has a washer and dryer that are fully operational located outside in the back of the home.

Refer to LIC 809C for the continuation of this report.