Facility Evaluation Report

On 11/08/2021 Licensing Program Analysts (LPA) Jose Calderon conducted an announced face to face visit to the facility for purpose of a pre-licensing evaluation. The requested capacity is for 5 ambulatory Adult Resident and one bedridden resident Facility (ages 18 through 59).

Facility is a 5 bedroom, 3 bathrooms, single-story house with attached garage. The client bedrooms are spacious and will easily accommodate the client's furnishings. There is a backyard with a covered patio for shade. The patio contained 1 small table and 6 chairs. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility . Residents Bedrooms: All 5 Bedrooms are for ambulatory clients. Bedroom’s #1, #2, #3 and #4 have one bed each and #5 has two beds. There is one dresser with drawers in Bedrooms #1 -#5 which comply with the requirement of 8 cubic feet of space. 3 Bathrooms : Have a working toilet, wash basins, and Full shower. LPA observed adequate lighting in hallway leading to bathrooms. Linens & Hygiene Supplies : Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen stored in hall closet.