Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA arrived at the facility was greeted and granted entry by Armin Claire Acasio, Applicant/Administrator.

A change of ownership application to operate an Adult Residential Facility for the Elderly, age 60 years and over, for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was submitted to CCL on 09/11/2023.

The facility is a one story house with an attached garage with 5 resident bedrooms, 1 staff bedroom, 2 full bathrooms, a living/dining room, and a kitchen. The resident’s bedrooms are spacious and will easily accommodate the resident’s furnishings. There is a large back yard with an exit walkway on both sides of the house with covered seating for the residents.

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

Bedrooms will accommodate 6 residents with 4 private rooms and 1 shared room accommodating two residents. Bedrooms #6 has a full bathroom. Bedrooms Staff: Bedroom #4 designated for awake-staff. Bathrooms: All bathrooms have a working toilet, wash basin, walk in shower. Linens & Hygiene Supplies: Adequate supply of linen stored in bedroom hallway storage. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed