Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA arrived at the facility and was greeted and granted entry by facility Consultant Kian Pascual. LPA met with Kian and designated Administrator (AD) Angelina Tevez. An application to operate an Residential Care Facility for Elderly (RCFE) for (6) capacity, (3) ambulatory, (3) non-ambulatory, and (0) bedridden residents was received by CCL on 8/12/2022.

The facility is a one-story home with five resident bedrooms, three bathrooms, living room, kitchen, staff bedroom, and an attached two car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the living room area. There is a back yard with two exit gates on each side of the house. There is a shaded seating area in the backyard. Bodies of water were observed to be fenced and secured. LPA did not observe any obstacles or hazards in the backyard.

All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened.

All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored and locked beneath the kitchen sink and in the garage.