Facility Evaluation Report

Licensing Program Analysts (LPAs) Sommer Hayes and Arvin Villanueva conducted an announced Pre-licensing visit to this facility on 05/07/25 and was met by the Applicant, Marilyn Mendoza Dela Cruz. A brief interview was conducted with the Applicant. This facility will be licensed as an Adult Residential to serve up to 4 ambulatory clients. There were no clients present during today's pre-licensing visit.

LPAs conducted an inspection of the facility including but not limited to the 4 resident bedrooms and two bathrooms, all of which contained the required furniture, furnishings, and lighting to be in compliance at the present time. All bedrooms had doors with locks to provide clients with privacy. Both bathrooms contained paper towels and soap.

Hot water temperatures were taken and measured at 111.9 F which is within the allowed range of 105-120 degrees. Linen closet, located in the hallway, was observed to contain a sufficient supply of towels and linens able to meet the needs of the residents.

LPAs inspected the kitchen, and all knives and sharps were in a locked drawer and inaccessible to future clients. LPAs observed enough plates, cutlery, pots, pans, and cups for future residents. Food supply for 2-day perishable and 7-day nonperishable quantities were reviewed to make sure that this facility was in compliance at this time.

LPAs observed the locked cabinet where medications for future residents will be stored so that they remain inaccessible to residents in care.