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 met with designated Administrator (AD) Marciel Nepomuceno. An application to operate a Residential Care Facility for the elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by CCL on 4/24/2023.

The facility is a one-story house with four client bedrooms, two full size bathrooms, one half bathroom, a living room, kitchen, dining room, enclosed patio, and attached two car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the kitchen. There is a backyard with one designated exit gate on one side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard.

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

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

Medication will be stored in a locked cabinet. First aid kit is stored in the pantry area. The first aid kit has all the required elements.