Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola, made an announced visit to the facility in order to conduct a prelicensing inspection. LPA met with Applicant, Tasha Hawkins.

The facility is seeking an initial application. The facility will be licensed as a adult residential facility, with capacity of (4) ambulatory clients. The facility does not have a pool or firearms. The home is a one story home with (4) bedrooms and (3) bathrooms.

LPA conducted a walk through of the interior and exterior of the facility. The bedrooms have all the required furniture, and required hygiene supplies, and linens. LPA observed the hallway lights and the carbon monoxide detectors were in good working condition. The outdoor area was free of any hazards and had a shaded area for residents and an emergency exit. The kitchen had the ability to prepared food is a clean and safe environment. The kitchen has the required food supplies for future residents. LPA observed areas where the staff and resident files would be kept as well as locked areas designated for medication, sharp objects, and cleaning supplies. The hot water temp was measures at 111.5F. The facility has a land line is operational at (951) 566-5392 . Emergency supplies such as water, food, first aide kits were observed during the time of the visit. The required postings were found in the facility.

There are no objections for the applicant to proceed in the prelicensing process. An exit interview was conducted with the applicant, and copy of this report was reviewed and provided to them.