Facility Evaluation Report

On 9/16/2021 LPA Tryon arrived at the facility to do a pre-licensing visit. LPA met with applicants Criselda Centeno and Anthony Bui. The home has passed fire clearance and is ready to occupy.

LPA toured the facility including common areas, kitchen, bedrooms, bathrooms, hallways, office, storage, garage and yard. There is central medication storage in the office and the office door locks. The home is clean and in good repair. No hazards were noted, there is no pool in the yard. Windows, doors, walls, screens, floors are in good condition. Temperature in the facility was comfortable. There are no stairways or ramps. Smoke detectors and carbon monoxide detector installed and functioning. Client bedrooms are nicely furnished with appropriate furniture, have plenty of storage/dresser/closet space. Beds with mattresses, pads, bedding present. There are adequate bathroom facilities for 4 residents. Hot water was tested and measured 110 degrees F, within the range of 105 to 120 degrees F. There are nightlights in the hallway. The home has appropriate hygiene supplies, bedding, towels, etc. Kitchen is in good condition, adequate supply of dishes, utensils, pots and pans, etc. There is a 7 day supply of non-perishable food. There is adequate storage for personnel and client records in the office. The home has set up folders for resident and staff files. Emergency exit plan posted, LIC 610. Personal rights posted, complaint poster, appropriate COVID posters.

There is adequate space in the yard for client activities and two sitting rooms in the house. Home has activity supplies.

First aid supplies present. Washer/dryer present. The home has an operating land-line telephone, emergency lighting available. Vehicle to be used for residents is licensed, appropriately insured and in good condition.

At this time the home appears to meet regulations.

Licensee has already been operating several other licensed ARFs for about 5 years. Therefore, Component III Orientation is waived at this time.