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 designated Administrator (AD) Divina Alipio. An application to operate a Adult Residential Facility (ARF) for (4) capacity, (3) ambulatory, (1) non-ambulatory, and (0) bedridden clients was received by CCL on 5/04/2023.

The facility is a one-story house with four client bedrooms, three bathrooms, two living areas, kitchen, dining area, an additional bedroom used for storage 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 on one side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard.

All client 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 clients and will be stored and locked in the garage.

Medication will be stored in a locked file cabinet. First aid kit is also stored in medication file cabinet. The first aid kit has all the required elements.