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 Licensee Davidson Alipio and designated Administrator (AD) Divina Alipio. An application to operate a Residential Care Facility for Elderly (RCFE) for (4) capacity, (3) ambulatory, (1) non-ambulatory, and (0) bedridden residents was received by CCL on 1/09/2023.

The facility is a one-story house with four resident bedrooms, two bathrooms, living room, kitchen, dining area, sun room, and attached two car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entranceway. There is a backyard with an exit gate each side of the house. There is a shaded seating area and 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 locked file cabinet. First aid kit is stored above medication file cabinet. The first aid kit has all the required elements.