Facility Evaluation Report
On May 2, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a pre-licensing inspection utilizing the inspection tool. LPA met with Applicant and Caregiver and explained the purpose of the visit.
LPA and Applicant conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: five residents bedrooms, one staff room, bathrooms, garage, kitchen, backyard and the common areas. LPA observed present of two fire extinguishers recently serviced. LPA observed the required compliance posters in the common area. LPA observed a designated locked space for medications, sharps and toxins. LPA observed facility to have the seven days of non-perishable food supplies present. Washer and dryer was observed to be in the garage, LPA reminded Applicant cleaning supplies are to be inaccessible to residents. LPA observed the resident bedrooms to have the required furnishings. LPA observed a pool in the backyard, pool gate is present with a lock. LPA observed the facility to be clean, sanitary and in good repair.
Comp III was conducted with Applicant. Additionally, LPA and Applicant discussed staff training, records, immediate $500 civil penalties. LPA provided facility with a copy of the following: LIC 311F, 1569.625 Staff training; legislative findings; contents, and 1569.69 Employees assisting residents with self-administration of medication; training requirements.
Pre-licensing inspection tool completed, the pre-licensing inspection passed. Applicant has satisfied all requirements in accordance to per Title 22, California Code of Regulations. CAB will be notified accordingly of licensure.
Exit Interview and copy of report provided to Applicant.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction