Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted a follow up visit to complete the Pre-licensing inspection. LPA met with applicant, Teodulo Bonzon and Administrator, Dominique F. Shakramy.

On 12/5/22, LPA Chan conducted the initial Pre-licensing inspection and the following needed to corrected and/or clarified:

* The fire inspection indicated a clearance for 34 ambulatory adults. However, during the inspection, the additional rooms are located in a separate building that is fenced off and has a different address of 2530 New Avenue. This will require clarification due to the address for this license is at 2526 New Avenue.

* Food supplies of at least a week of non-perishable were not maintained at the facility.

During the visit today, LPA performed a final walk through.

* The licensee submitted a revised capacity change from 34 to 32. On 12/9/22, the fire clearance has been approved for a capacity of 32 ambulatory only adults.

* The non-perishable food supply of at least a week are observed in one of the garage space.

The Pre-licensing deficiencies have been resolved. Pre-licensing is now complete. An exit interview was held and a copy of this report was provided to Dominique Shakramy.