Facility Evaluation Report

On 08/11/2022 Licensing Program Analyst (LPA) Don Senaha conducted an announced visit to the above facility for the purpose of a pre-licensing evaluation. LPA met with Administrator, Elnaz Mayeh and explained the purpose of the visit. During the inspection LPA toured the inside and outside of the facility and verified the address of the location.

An application was submitted to Community Care Licensing Division (CCLD) on 08/04/2022 for a Pre-licensing for a Social Rehabilitation Facility. The total requested capacity is for 6 clients. Facility has a fire clearance dated on 07/14/2022 for 6 ambulatory clients only.

Structure: Facility is a three-story house. The facility has three (3) shared client bedrooms. The first floor consists of the nurse office with a bathroom, therapy office with a bathroom, common bathroom, dining room, group therapy room, kitchen with dining area, living room and access to the garage used for arts and crafts. The garage also consists of extra storage for the pantry food items and two refrigerator/freezers for food storage. The second floor consists of bedroom (1-3). All three (3) bedrooms has its own bathroom. The second floor also consists of a storage area under the stairwell, common bathroom, laundry room and staff office with bathroom. The third floor consists of the library area for clients and staff office area. There is access to the back of the house on both sides of the facility through a gate. The backyard contains a shaded area with seating, bbq area and lawn area for games. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as gardening tools and/or motorized equipment in the front, back and/or side areas of the facility.

Bedrooms: All three (3) client bedrooms have a chair, nightstands, over-head lighting, dressers and/or closets. The closets and drawers comply with the requirement of 8 cubic feet of space.