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 Mary Han. An application to operate an Residential Care Facility for the Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by CCL on 9/27/2023.

The facility is a one-story house with four bedrooms, two bathrooms, living room, kitchen, dining room, laundry room, and attached two car garage. There is a backyard with an exit gate each side of the house. 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. 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 underneath the kitchen sink.

Medication will be stored in a medication cabinet mounted on the wall in the kitchen area. First aid kit is mounted on the wall in the living room. The first aid kit had all the required elements, but was missing a thermometer.