Senior Care Records.

Facility Evaluation Report

Evergreen Adult Home Care, Orange04/27/2023Licence 306006251

Capacity6
Census5
Date signed04/27/2023 09:35:21 AM
The inspector’s account

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection to follow up on corrections identified during visit on 03/20/2023. LPA arrived at the facility and was greeted and granted entry by designated Administrator (AD) Tamanna Rahman. House Manager Tawsique Salam was also present. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden residents was received by CCL on 10/14/2022.

At 9:00 a.m. LPA toured the facility and observed the following:

· Light switch located in the stairway has been aligned and no longer has a gap between the switch cover and the wall.

· Baseboard along the walls upstairs has been installed and there is no longer a gap between the flooring and walls.

· In the entrance way of the facility dry wall previously observed to be drying has been painted over and is seamless to wall.

All noted items from visit on 03/20/2023 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.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction