Facility Evaluation Report

On 12/20/24, Licensing Program Analyst (LPA), Regina Cloyd, conducted an announced visit to the facility for purpose of a prelicensing evaluation. An application was submitted to CCLD on 09/11/2024, for Change of Ownership for a Residential Care Facility for the Elderly to serve the Elderly for ages 60 years and older. The requested capacity is for six residents, four (4) non-ambulatory and two (2) bedridden. Bedroom #5 is designated for two bedridden residents.

Facility is a five (5) bedroom, three (3) bathroom, single story house with an attached car garage. It includes a kitchen and dining and living room. There is a shaded porch area on the premises. The residents’ bedrooms are spacious and will easily accommodate the residents’ furnishings.

Bedrooms #1 – 4 are for non-ambulatory residents. Bedroom #5 is for two (2) bedridden residents. Bedrooms have beds, chairs, nightstands, adequate lighting, and dressers and/or closets.

All three (3) bathrooms have a working toilet, wash basin, bath-tub/shower. Bedrooms #1 – 2 have private bathrooms. Continue to LIC809-C.