Facility Evaluation Report, 11/21/2023 — Mercedes Diaz Homes, INC.

Licensing Program Analyst (LPA) Jose Villalobos conducted an announced visit with applicant Applicant Alejandro Hernandez. The purpose of the visit was to conduct the Pre-Licensing for the facility listed above.

An application was submitted to CCLD on 4/23/2023, for a Change of Corporation of an Adult Residential Facility. Application requested a capacity of 4 clients and has an approved fire clearance for up to (4) Bedridden clients. Facility is currently operating under active license # 198601678.

The facility is part of a single story home located in a residential area and contains the following: living room, dining room, office, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, locked storage cabinet for medications and sharps, (4) client rooms, (2) bathrooms for clients; bathrooms with shower, toilet and washbasin. A back yard with shaded area and seating for resident use. A connected garage inaccessible to clients for storage, with washer and dryer. The residence is equipped with air conditioning

Accommodations : Adequate accommodations observed throughout facility. Lighting: Sufficient Lighting throughout. Hallway and Doorways: Free and clean of obstruction and debris. Client Rooms: Bedrooms #1-#4 are for up to (1) bedridden Client each. All bedrooms are equipped with: overhead lighting, chair, night stand, lamp in addition to overhead lighting, large drawer, and closet space, and beds for each resident. Bathrooms: Bathrooms have a working toilet, wash basin, shower, grab bars and nonskid mats. Linens & Hygiene Supplies: Required linen/supplies which include, pillowcase, fitted sheet, blankets, bedspreads. Mattress pads were observed. Emergency Phone Numbers, Exit Plan & Menu: Facility has a working phone landline. There is (1) cordless phone for client use. Fire Extinguisher fully charged and up to date. Food Service: All food and adequate utensils such as, dishes, cups, bowls and plates are stored at the other location until residents move in. Knives, cutlery and other sharps inaccessible to clients kept in a locked cabinet....