Facility Evaluation Report
On 10/06/2022, Licensing Program Analyst (LPA) Avelina Martinez arrived announced to conducted a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA Avelina Martinez met with Editha Guevarra, who assisted LPA Martinez in today’s inspection.
Facility has a fire clearance for 3 ambulatory residents and 1 non-ambulatory resident. Administrator, Editha Guevarra, will be the Administrator of this facility. The facility administrator’s certificate expires 11/2023.
LPA Martinez inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen.
The facility has Covid-19 postings throughout the facility, and has a Covid-19 Mitigation plan. In addition, the facility has one main Covid-19 screening entry, and has a supply of PPE. The facility has also submitted an infection control plan. The facility furniture is spaced 6 feet apart, and in good repair. All resident bedroom were in good repair and furnished, and the facility bathrooms were in good repair. Additionally, facility hallways had night-lights.
The facility kitchen is in good repair, and has locked cabinets to sharp objects and knifes. The facility also has a public telephone, and has a space for activities. Moreover, facility staff and resident files have been created. The exterior of the facility is in good repair, and the emergency exit gate is in good repair.
The applicant has passed the pre-licensing component of the application process. LPA Martinez will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. LPA Martinez conducted Component III.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction