Facility Evaluation Report

On 06/29/2023, Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced to conduct a Pre-Licensing Inspection. This facility is undergoing a change-of-ownership. LPA met with Facility Representatives, Susana Magana and Marie Rivera . This facility has a fire clearance for 4 non-ambulatory.

LPA toured and inspected the indoor and outdoor premises of the facility with Facility Representatives to ensure there are no health and safety concerns. Indoor and outdoor passageways were free of obstruction. LPA observed the common areas, bedrooms, bathrooms, medication room, laundry room, garage, and backyard. LPA observed required furniture, and lighting throughout the residents' bedrooms and facility. LPA observed fire detectors and carbon monoxide present at the facility. Bathrooms are clean, sanitary, and in good repair. LPA observed food supplies of non-perishables for a minimum of one week and perishable foods for a minimum of two days. LPA observed knives/ sharps area were locked and inaccessible to clients in care. Toxic and cleaning supplies locked in the laundry room and garage. The hot water temperature was measured in the kitchen at 111 degrees Fahrenheit. LPA observed a total of 4 fire extinguishers serviced on 06/26/2023.

LPA went over Component III with Administrator. LPA observed that the facility is ready to be licensed. This report will be submitted to the Central Applications Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required.

Exit interview conducted and report provided.