Facility Evaluation Report

Licensing Program Analysts (LPAs) Ruth Martinez and Hanna Gough conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA arrived at facility was greeted and granted entry. LPA met with Benjie Dizon, applicant.

An initial application to operate an Adult Residential Facility for the Elderly, age 60 years and over, for (14) capacity, (0) ambulatory, (14) non-ambulatory, and (0) bedridden resident was submitted to CCL on 04/24/24.

The facility is a one story house with an attached garage with 7 resident bedrooms, 3 full bathrooms, 1 half restroom, a living room, a dining room, a kitchen. The resident’s bedrooms are spacious and will easily accommodate the resident’s furnishings. There is shaded seating areas in the backyard for resident and an exit walkway on each side of the house. Air/Heating: Central air/heating system installed with a central panel to control entire house. Bedrooms Residents: Bedrooms will accommodate 14 residents with 7 bedrooms being shared. Bedrooms #6 & 7 have their own bathroom. Bedrooms Staff: No staff designated bedroom. Bathrooms: Facility has 4 full bathrooms and 1 half restroom. All bathrooms have a working toilet, wash basin, walk in shower. Linens & Hygiene Supplies: Adequate supply of linen in storage. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food serve for one week. Food Service: Adequate supply of 7-day non-perishable and 2-day perishables will be stored in the kitchen. Additional food storage in garage in spare refrigerator