Facility Evaluation Report

On 11/08/2021 Licensing Program Analyst (LPA’s) Venus Mixon and David Cuevas conducted an announced visit for the purpose of a pre-licensing inspection. LPA ‘s met with Administrator/Licensee, Alma Natividad and Roderick Natividad and were granted entry. LPA’s took a tour of the interior and exterior of home. The home will be licensed for a total capacity of (4) ambulatory residents ages 18 through 59 years.

LPA was informed that no firearms or ammunition will be kept at facility. The Licensee/Administrator, Alma Natividad, has a current Administrator's Certificate (expires 04/03/2022).

LPA observed the home as follows: The home is single story 4-bedroom, 3-bathroom home with an attached garage next to laundry room. There is dining area next to kitchen with ample sitting area. Additionally, staff office is located next garage and will be utilized to store resident and staff files under lock and key. LPA observed no pools or bodies of water within the premises.

LPA's observed the bedrooms to be furnished with a bed, dresser, nightstand, and appropriate lighting. The bathrooms have grab bars for resident’s safety and non- skid mats or strips in tubs and showers. LPA’s observed bathrooms to have enough soap and paper towels for use. LPA observed the home to have ample supply of extra towels and linens for resident’s use. Medications will be locked and stored in staff office within a locked cabinet. LPA's observed a complete first aid kit and manual within staff office.

The kitchen was stocked with pots, pans, cook ware, dishes, and silverware. Knives and other sharp items will be locked and stored in kitchen cabinet under locked key.