Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez made an announced visit to conduct a Pre-Licensing inspection. LPA identified herself and was granted entry into the home. An initial application to operate an Adult Residential Facility was submitted to Community Care Licensing on 04/25/2024 for a capacity of six (6) Ambulatory clients. Administrator Catherine Mendoza has an Administrator certificate valid until 01/31/2025. Upon entry, facility appears clean, safe and sanitary.

LPA along with Applicant toured the facility and observed the following:

Structure: Facility is a one story, 5 bedroom, 2 bathroom house with an attached garage and a gray exterior. Facility has an office for Administrative work. Living Room/ Dining Room : Adequate seating is available in the dining room and living room. Bedrooms Clients: Two rooms will be single occupancy and other two will be double occupancy. All rooms are equipped with appropriate lighting, chair, night stand and ample closet space. Bathrooms: Client bathrooms have a working toilet/wash basin. Facility has sanitizer/soap in the bathrooms. Linens & Hygiene Supplies: Facility has adequate bedding, towels and hygiene supplies for clients in care. Emergency Phone Numbers and Exit Plan: Emergency plan/phone numbers located in facility entrance. Food Service: Applicant has some food but understands to have a 2 day supply of perishables and a 7 day of non-perishables at all times when clients are present. There are no clients present during this inspection. LPA observed ample emergency food and water as well as a facility menu. Smoke Detectors: Smoke detectors/carbon monoxide detectors are hard wired and were tested operational. Fire extinguishers are mounted and charged. Appliances: Stove, oven, refrigerator, microwave, washer, and dryer are clean and operational. Toxins / Sharps : Facility has secured area for toxins/sharps under kitchen sink. Water Temperature: Tested and hot water temperature was within regulatory requirements.