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 arrived at the facility and was greeted and granted entry by designated Administrator (AD) Minerva Sansano. 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 CCL on 12/21/2022.

The facility is a single-story house with six resident bedrooms, two bathrooms, living room, kitchen, dining room, laundry room, staff break room, and attached two car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the living room entrance area. There is a back yard with two exit gates, one on each side of the house. There is a shaded seating area in the backyard. LPA did not observe any obstacles or hazards in the backyard.

All resident bedrooms had the required furnishings. LPA observed all resident 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 residents and will be stored and locked beneath the kitchen sink and in a locked storage cabinet in the garage.