Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr made an announced inspection to the facility for purpose of conducting a pre-licensing inspection. LPA arrived at the facility at and was greeted by Administrator Richard Michael Sayat, Backup Administrator Anna Mallari and Licensee Francis Mallari. An application to operate a Adult Residential Facility (ARF) for (4) capacity, (0) ambulatory, (4) non-ambulatory, and (0) bedridden clients was received by Community Care Licensing (CCL) on 6/6/2023.

Structure: The facility is a one-story home with four client bedrooms, two bathrooms, living room, kitchen, dining room, two staff rooms, laundry room, storage room, an attached two car garage and backyard. The garage, storage room and staff rooms remain locked to restrict resident access. There is a back yard with two exit gates. There is one shaded seating area. Licensee stated they will be providing an additional table and chairs that have already been purchased. LPA did not observe any obstacles or hazards in the backyard.

Client Bedrooms: All client bedrooms have the required furnishings. LPA observed all resident beds have linens and blankets. LPA observed all windows were screened.

Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients and are stored and locked in cabinets in the laundry room.

Medication, First Aid Kit and Files: All of these items will be locked in cabinets in the dining room

Smoke/CO2 Detectors & Fire Extinguisher: Dual smoke/CO2 detectors were tested and observed to be operational and connected. LPA observed the fire extinguisher to be fully charged with receipt indicating it was purchased on 10/05/2023.

Activity Materials: The facility has board games that are stored in the living room.