Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an announced Pre-Licensing visit for a Change of Ownership (CHOW) and name change. LPA met with Administrator Melissa Lopez and was granted entrance to the facility.

The facility has an approved fire clearance to be licensed to serve four (4) total ambulatory clients, and is also currently serving four (4) ambulatory clients. The facility is a single-story home located in a residential neighborhood in the city of Whittier. The facility consists of a dining room, living room, kitchen, three (3) client bedrooms, an office, a laundry room, three (3) bathrooms, as well as a back yard that contains a shaded area and a detached garage. The hot water temperature in the facility measured between the required range of 105 - 120 Degrees Fahrenheit.

The following was inspected during the evaluation with the Program Center Director and determined to be compliant with Title 22 Regulations. A locked storage area for central storage of medications was observed in one of the main hallways of the facility. Cleaning supplies are kept separate from food supplies and are stored in the locked supply closet which is located in the laundry room of the facility. The walls, ceilings, floors, window screens and areas around the facility were clean and in good repair. There is a fire extinguisher kept in the dining room of the facility. The carbon monoxide and smoke detectors are interconnected and was observed to be operational. Doors, exits, hallways, and passageways were clear and free of obstruction. The front and back areas of the facility were observed to be clean and free of debris.

No pools or bodies of water were observed in or around the facility. An operating telephone was observed on the premises, which is easily accessible and available for resident use. The refrigerator was observed to be operable at 41 degrees and freezer below 0 degrees. The first-aid kit was reviewed and is kept locked in a main hallway of the facility.

COMP III was waived due to the CHOW. Exit interview held and a copy of the report was provided.