Facility Evaluation Report

On today's date, Licensing Program Analyst (LPA) Rosie Quiroz conducted an announced visit to the facility for purpose of a Change of Ownership Pre-Licensing evaluation inspection visit. LPA Quiroz was greeted and granted entry and met with Michelle Kellogg, Licensee, Donnavee Lalap, Administrator and Kian Pascual, Administrative Assistant.

An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Unit (CAU) on 6/20/2022 for a capacity of six (6) residents, five (5) Non-Ambulatory residents and (1) one bedridden resident.

Administrator Donnavee Lalap has an Administrator Certificate with expiration date of 3/10/2024.

LPA Quiroz provided consultation on Title 22 California Code of Regulations (CCR) and on new Inspection Tool.

At approximately 9:27am, LPA Quiroz along with Administrator Lalap commenced the inspection tour.

During today's inspection visit, LPA Quiroz observed the following:

Structure: Facility is a one story building, consisting of: 6 private resident bedrooms, (1) one caregiver bedroom, (2) two full bathrooms, and (2) two half bathrooms. Bedroom #5 is designated as bedridden resident bedroom only. The resident bedrooms will accommodate residents' furnishings. There is one living room, kitchen, dining room area, Common Family Room, 2 car garage with operational washer and dryer, and back yard with shaded area and outdoor furniture for residents and visitors enjoyment.

Toxins: Will be locked and stored in secured closet in garage area, not accessible to residents in care.