Facility Evaluation Report

The pre-licensing visit was conducted by Licensing Program Analyst (LPA), Sandra Urena. The LPA arrived at the facility at 1:00 p.m., and met with applicant Elliott Liebhard, and facilities director Katarina Boshoff. This is a new facility application for six ambulatory residents.

The LPA, the applicant, and the facilities director toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN : Kitchen knives are stored locked and inaccessible in the pantry room. A seven day supply of non- perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. There is an adequate supply of emergency food. Kitchen, laundry, and house cleaning supplies are stored, locked, and located in the laundry room. Hot water temperature was recorded at 116 degrees Fahrenheit.

BEDROOMS : There are three bedrooms for resident use, double occupancy. Lighting in the rooms appeared adequate. All bedrooms had adequate closet and drawer space for clothing and personal belongings. Hot water was tested in residents’ bathrooms; it measured 116 degrees Fahrenheit.

BATHROOMS : The bathrooms are fully stocked with paper towels, hand soap, and hand washing signs. The showers have non-skid mats. Hot water temperature was recorded at 116 degrees Fahrenheit.