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 met with designated Administrator (AD) Andre Bui. An application to operate Residential Care Facility for the Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by CCL on 9/18/2023.

The facility is a one-story house with three client bedrooms, two bathrooms, living room, kitchen, laundry room, and attached two car garage. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall in the entranceway. There is a backyard with an exit gate each side of the house. There is no shaded seating area and LPA observed obstacles and hazards in the backyard, including: a jagged edged gardening tool, a trash can laying on its side, a discarded cleaning brush and toothbrush, a picketed white wood door missing a picket leaning against a brick wall, and overgrown grass and weeds.

All client bedrooms had the required furnishings. Beds were observed to have linens, however, did not have blankets or comforters.

All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored and locked underneath the kitchen sink and in the laundry room.