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 facility was greeted and granted entry. LPA met with Stevelyn Reroma, applicant and explained the visit.

An initial 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 resident was submitted to CCL on 10/08/24.

The facility is a two story house with an attached garage with 5 resident bedrooms, 1 full bathroom, 3 half restrooms, a living room, a dining room, kitchen on the first floor. The second floor of the facility will be occupied by live in staff with one bedroom and 1 full bathroom. Access to staircase is the door leading to the garage which can be locked for inaccessibility to resident, no resident will reside on the second floor. The resident’s bedrooms on the first floor are spacious and will easily accommodate the resident’s furnishings. The back yard has seating areas for resident and an exit walkway on each side of the house. Air/Heating:

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

Bedrooms will accommodate 6 residents with 1 shared room accommodating two residents. Bedroom #1 approved for bedridden residents, Bedroom #2, 3, 4 approved for 1 non-ambulatory resident each. Bedroom #5 approved for 2 non-ambulatory residents. Bedrooms Staff: Second floor is designated for live in caregivers. Bathrooms: Facility has 1 full bathroom on the first floor and 3 half restrooms in bedroom #2, 3, & 5. All bathrooms have a working toilet, wash basin, walk in shower. Second floor has 2 full bathroom 1 bedroom, kitchen and a living room.