Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted an announced visit to the facility for the purpose of a pre-licensing evaluation. LPA met with the Administrators, Shahbaz Baig and Dominique Felbaum, who provided assistance with the tour of the physical plant. The applicant, Teodulo Bonzon was also present at the facility.

An application was submitted to CCLD for a Change of Ownership for an Adult Residential Facility. The fire clearance has been approved for a capacity of 34 Ambulatory adults only. There are currently 31 individuals residing at the facility.

LPA inspected the facility using the Pre-licensing Inspection tool and observed the following:

Structure: Facility is a one-story building which consists of 16 client bedrooms, 9 bathrooms, living room, dining room, activity room, kitchen, laundry room, and 2 detach garages. There are no pools or bodies of water at the facility. There is a shaded outdoor patio in the rear for clients to use.

Bedrooms: There are 16 bedrooms and furnishing equipped for each client - a bed, nightstand, adequate closet space, a chair, and lighting.

Bathrooms: There are a total of 9 bathrooms. There are 7 communal bathrooms and one designated for staff. Room #10 has a private bathroom.

Staff and Client files: Staff and Clients files are stored and maintained at the facility. The facility has an updated client roster and emergency contact information.

Linens & Hygiene supplies: Extra supplies of linens are observed locked in storage cabinets in the hallways. Extra hygiene supplies are stored in the office.

Appliances: All appliances in the facility are in good repair.