Facility Evaluation Report

Licensing Program Analysts (LPAs) Cynthia Chan, Mayra Cota, and Luis DeLeon conducted an announced prelicensing inspection on 12/12/24. LPAs met with applicant/administrator, Diana Rojas.

The fire clearance has been approved for a capacity of 4 ambulatory only adults, ages 18 through 59. There are currently no individuals residing at the facility.

LPA inspected the facility using the Pre-licensing Inspection tool and observed the following. Component III was also completed during the visit today.

Structure: Facility is a one-story home consisting of 4 client bedrooms, 2.5 bathrooms, living room, dining room, kitchen, nook, laundry room, and detached garage. There are no pools or bodies of water on the premises. There is a shaded outdoor patio in the rear for clients to use.

Bedrooms: There are 4 private bedrooms and furnishing equipped for each client such as a bed, nightstand, adequate closet space, a chair, and lighting.

Bathrooms: There are a total of 2.5 bathrooms. There are 2 communal bathrooms and a half bath in bedroom #3.

Surveillance: The facility uses surveillance monitors in the common areas, living room, dining room, and kitchen.

Staff and Client files: Staff and Client files will be maintained at the facility. Staff files will be locked in the nook area.

Linens & Hygiene supplies: Extra supplies of linens and hygiene are observed in storage cabinets. There are sufficient amount of linens available to permit weekly changing.

Appliances: There is a stove, oven, washer and dryer. The stove burners were not operable at this time.