Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez made a visit to the facility to conduct an announced Pre-Licensing evaluation with a Component III. Upon arrival, LPA met with Applicant Anamika Ahluwalia and Direct Staff Anish Gore. An initial application to operate an Adult Residential Facility (ARF) was submitted to the Central Applications Unit (CAU) for a Capacity of 4 (all Ambulatory) clients. The Fullerton Fire Department conducted a Fire Safety Inspection on 03/03/2022 and Fire Clearance was granted. A tour of the physical plant was conducted inside and out at approximately 01:00 PM with Applicant and Staff and the following was observed:

Facility is a one story house with 4 bedrooms and 2 bathrooms. Bedrooms will be single occupancy. Facility will have no live-in staff. There is a kitchen, dining area, and living room.

Central air/heating system installed with a central panel to control entire house.

The client bedrooms accommodate clients' furnishings and meet Title 22 regulation at this time.

The 2 bathrooms have a working toilet, wash basin, and shower. Grab bars and non-slip mats were present.

Adequate supply of linens and hygiene items were observed

Ombudsman Poster, Personal Rights and See Something Say Something Poster

Personal Rights and the See Something Say Something are posted. Ombudsman poster will be requested after licensure.

Facility has no clients during this visit. Applicant understands a supply of 7-day non-perishable and 2 day perishables and fruits and vegetables must be available when clients present at all times.