Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an announced Pre-Licensing visit and met with Administrator Gil Calingasen Administrator and Doctor Harold Fajardo Licensee for the purpose of conducting a Pre-Licensing Inspection / Component III visit. This was the facility’s first Pre-Licensing Inspection.

The facility has an approved fire clearance to be licensed to serve four (4) ambulatory clients. The facility is a one-story home in a residential neighborhood. It contains three (2) bedrooms, two(2) shared and one (1) full bathroom and one half bathroom by laundry area., a living room, a dining room, , a kitchen, an unattached garage, and a back yard patio area located in Monterey Park, CA

The physical plant was toured inside and out alongside Gil Calingasen Administrator and Doctor Harold Fajardo Licensee. The Pre-Licensing Inspection Tool was used.

· Cleaning supplies are kept separate from food and located in a locked cabinet under the kitchen sink.

· Facility wall in one client room needs cleaning or painting, door also requires locking knob. ceilings, floors, window screens and areas around the facility are clean and in good repair. Window in the one shared room needs repair or replacement. In same room, the strip on the edge of door needs to be removed or have a doctor’s order as door is not able to close with the strip on the edge of the door.

· Fire extinguisher and smoke detectors operate properly.

· Doors and passageways are free of obstruction.

· There are no pools/bodies of water at the facility.

· Facility does not have firearms on premises.