Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection. LPA arrived and was greeted and granted entry by Licensee Rosario Dacayo. An application to operate an Adullt Residential Facility (ARF) for (4) capacity, (4) ambulatory, (0) non-ambulatory, and (0) bedridden clients was received by Community Care Licensing (CCL) on 08/25/2023.

The facility is a one-story home with four client bedrooms, three bathrooms, staff office, living room, dining room, kitchen, attached two car garage, covered patio and backyard. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entryway. There is a back yard with two exit gates. There is a covered patio with seating area in the backyard. LPA did not observe any obstructions blocking the exit gates or obstacles or hazards in the backyard.

Client Bedrooms have all the necessary requirements including bed, chair, storage for clothing and ample lighting. LPA observed all windows were screened.

All bathrooms have working plumbing and designated hand washing posters. In the master bathroom, hot water measured at 110.4 degrees Fahrenheit. In the bathroom nearest to Room 2, hot water measured at 111 degrees Fahrenheit. In the bathroom nearest to the kitchen, hot water measured at 115 degrees Fahrenheit.

LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients and are stored and locked in a cabinet in the kitchen and in a closet in the living room.

Medications, First-Aid Kit, Resident & Staff Files will be locked in cabinets in the dining room.