Facility Evaluation Report

Licensing Program Analysts (LPAs) Claudia Gutierrez and Michelle Reed made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPAs arrived at the facility and were greeted and granted entry by Administrator (AD) Allen Medina. LPAs temperature was checked upon entry and a hand sanitizing station was observed. An application to operate a Residential Care Facility for Elderly (RCFE) for a capacity of 6 non-ambulatory residents of which 1 may be bedridden was received on 1/10/2022 by Community Care Licensing (CCL).

The facility is a one-story home with 4 resident bedrooms, 2 bathrooms, living room, kitchen, staff break room, and an attached two car garage. In the backyard there. LPAs observed the Ombudsman and the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the dining area. LPA observed there are door alarms on the front door and all exit doors. There is a back yard with one exit gate on the side of the house and has an auditory alarm. LPA tested the door alarm and it was operational. There is a shaded seating area in the backyard. No bodies of water observed. LPAs did not observe any obstacles or hazards in the backyard.

All client bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets. LPAs observed all windows were screened.

Residents have individual pendants to alert staff.

All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored and locked in the supply closet.