Facility Evaluation Report

On July 16, 2024 at 10:00 AM, 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 Martinez met with Anali Gonzalez who assisted LPA Martinez in today’s inspection.

The facility has a fire clearance for four ambulatory residents. The current census is zero. The Administrator holds a current certificate.

LPA Martinez inspected the interior and the exterior of the facility including the common living spaces, client bedrooms and bathrooms, and kitchen. The facility is sanitary and and furnished. The facility has a public telephone. The facility has no large bodies of water. The exterior of the home is clear of debris and has a shaded patio. The exterior emergency exit gate is in good repair. Fire extinguisher, carbon detectors, and smoke detectors are in good repair. In addition, the facility has a first aid kit, and has a secured locked room for medication storage. The facility has a laundry room, which all toxins and cleaning supplies with stored in a locked cabinet. The facility has created files for the the following: clients, staff, and medications.

The applicant/administrator of this facility has a current administrator certificate. Additionally, the applicant/Administrator currently is associated to another facility, and they have experience with component three. Therefore, this portion of the pre-licensing visit has been waived.

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.

An exit Interview was conducted, and a copy of this report was provided to the applicant/Administrator.