Facility Evaluation Report

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility announced at 1:00 p.m. to conduct a pre-licensing inspection. The LPA met with applicant Izhak Illouz. This is a new facility application for six (6) resident’s. Rooms are cleared for five (5) non-ambulatory residents and one (1) bedridden resident. The fire clearance was granted on 4/8/2022; in which one (1) bedridden resident is permitted in Bedroom #5. Component III was waived as the applicant currently operates two other Residential Care Facilities for the Elderly (RCFE)’s that are currently in good standing. Applicant has attended Component III in the past and is RCFE administrator certified.

At 1:10 p.m., the LPA toured the physical plant areas inside and outside with the applicant 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 a drawer on the left hand side of the stove. The supply of perishable and nonperishable food is adequate. The supply of dishes is adequate. Appliances in the kitchen were clean and appeared functional. There is an adequate supply of emergency food. The facility recently completed a full home remodel, in which appliances and cabinets were replaced.

BEDROOMS : There are (7) seven bedrooms in the facility; the facility has (6) six private bedrooms for resident use, and (1) one staff room. The staff room is kept locked. Room #3, #5 and #7 have direct access to the outside. Lighting in the rooms appeared adequate. (6) six out of (6) six private resident rooms and (1) staff room were set up with beds, night stands, lamps, chests of drawers, chairs and closet space.

BATHROOMS : There are (6) six full bathrooms. There are five (5) private bathrooms for resident use; the full bathroom near the entrance of the home next to the kitchen is designated for staff and guests. The showers are equipped with nonskid surfaces and available nonskid mats. Grab bars were observed in the bathrooms. Hot water temperature in bathrooms measured between 110.4 – 119.8 degrees Fahrenheit.