Facility Evaluation Report

On 06/11/2024 at 8:29 AM, Licensing Program Analyst (LPA) Pang Lee arrived announced to conduct a Pre-Licensing Inspection follow-up of the facility to ensure compliance with Title 22 regulations. LPA Lee met with licensee, Chris Faamausili who assisted in today’s inspection.

Noel Estilore will be the administrator to this facility. Administrator certificate number # is 6033614740 and will expire on 02/09/2025. The facility has a fire clearance for 6 non-ambulatory residents to accept and retain at any given time. The facility will employ staff who are live-in caregivers. The facility will ensure that there is always at least one caregiver present in the facility at all times. There were no residents in care at this time. LPA Lee toured the facility with Chris and reviewed the updated facility sketch and the facility sketch aligned with the facility. During today's visit, all corrections were completed.

* Licensee/Administrator will ensure that an updated plan of operation to include live in staff- Completed, on 05/31/2024, licensee emailed LPA Lee an updated plan of operation to include live in staff and expectations.

· Licensee/Administrator will ensure that an updated facility sketch to include the four cameras in the home, the staircase closet, and the detached garage- Completed, on 05/31/2024, licensee emailed LPA Lee an updated facility sketch which reflected the four cameras in the home, the staircase closet and the detached garage. The up dated plan of operation also included the expectation of the cameras in the home.