Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection visit to follow up on corrections identified during visit on 05/10/2023. LPA arrived at the facility and was greeted and granted entry by designated Administrator (AD) Maureen Salonga. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by Community Care Licensing (CCL) on 1/23/2023.

At 9:05 a.m. LPA toured the facility and observed the following:

Four out of four bedrooms have all the required elements.

Emergency phone numbers, Theft and Lost Policy, “Rights of Resident Councils” and food menu are posted and visible.

Fireplace was observed to have a fireplace screen.

Two out of two resident bathrooms have non-skid mats.

All noted items from visit on 05/10/2023 have been addressed.

The facility is ready to be licensed. An exit interview was conducted, and a copy of this report was left at the facility.