Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman made an announced visit to conduct a pre-licensing inspection. LPA identified herself and discussed the purpose of the visit with Administrator Bhonalyn Ladia and the management team. An initial application to operate a Residential Care Facility for the Elderly was submitted to Community Care Licensing on 12/10/2024 for a capacity of six non-ambulatory residents. Upon entry, facility appears clean and sanitary. Facility has all required postings at entrance. Administrator Bhonalyn Ladia has an administrator certificate expiring on 01/29/2027. This pre-licensing is a change of ownership with six residents present during today's visit.

LPA Lyman along with Administrator Ladia and Director of Operations Joanna Gomez toured the facility at 1:08 PM and observed the following:

Structure: Facility is a one story, 6 bedroom, 3 bathroom home with living room, dining room, kitchen and den. There is an attached garage and a tan exterior. One bedroom is reserved for staff. LPA observed night lights in hallway of facility. Living Room/ Dining Room : Adequate seating is available in the dining room and living room. Bedrooms Residents: Rooms will be single and double occupancy. All rooms are equipped with appropriate lighting, chair, night stand and ample closet space. Auditory exit alarms are operational. Linens & Hygiene Supplies: Facility has ample bedding and towels in supply. Bathrooms: All resident bathrooms have a working toilet/ wash basin as well as grab bars and non-skid surface in the shower. Emergency Phone Numbers and Exit Plan: Posted in the entrance of the facility. Food Service: Facility has 2 day perishables as well as 7 day non-perishables. Smoke Detectors: Smoke detectors/ carbon monoxide detectors are centrally wired and were tested operational. Fire extinguishers are fully charged. Appliances: Stove, oven, refrigerator, microwave, washer, and dryer are clean and operational. Toxins / Sharps : Facility has multiple secured areas for toxins and sharps. Water Temperature: Tested and recorded between 110.6 and 118.2 degrees F. in facility bathrooms. Emergency Supplies: LPA observed ample emergency food and water as well as a posted emergency disaster plan. Facility has additional emergency supplies present including flashlights. Licensee has multiple generators stored off-site for emergency use. CONT ON LIC 809C DATED 02/06/2025