Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an announced Pre-Licensing visit using the CARE Tool. LPA Mora met with Joseph Jose (Applicant) and explained the reason for the visit. The Community Care Licensing Division received a Change of Ownership application for a Adult Day Program to serve 60 ambulatory and 30 non-ambulatory clients.

The program consists of 1 large single-story building. A tour of the single-story building included: reception area, 4 offices, 2 client and 1 staff restroom, 1 isolation room, 1 relaxation room, kitchen, 2 activity rooms, conference room, and storage room. LPA toured the facility with Joseph Jose and the following was observed: a total of 10 clients were at the facility during the visit. The staff to client ratio is 1:3. The program site is clean, safe, sanitary and in good repair. All passageways are free from obstruction. Disinfectants, cleaning solutions and poisons are inaccessible to clients and are locked inside a cabinet. There are four fire extinguishers and are fully charged. Facility has an interconnected smoke and carbon monoxide system. The restrooms were observed to be clean and have the required grab bars for non-ambulatory clients. The water temperature was tested in all 3 restrooms and it measured between 105.8 degrees F which is within the required 105-120 degrees F. The program maintains a comfortable temperature in each room/office. The First Aid kit is kept in the kitchen and it is fully stocked with all required items including a current manual. Facility does not keep or administer medications. Food is not prepared at this program and clients are able to bring their own food. The kitchen area has a refrigerator where the clients can store their food. Sharps are kept locked in an office. There are lockers for the clients. The last fire/emergency disaster drill was conducted on 12/04/2023 and earthquake drill on 12/04/2023. LPA reviewed 5 client and 5 staff records.

No outstanding or pending items were observed by the LPA requiring additional pre-licensing visits. LPA will notify the assigned Centralized Applications Bureau (CAB) Analyst of the completed pre-licensing facility evaluation visit conducted, which included the Component III Orientation.

Exit interview conducted and a copy of this report was provided.