Facility Evaluation Report

Licensing Program Analyst (LPA) Anna Bueno conducted an announced visit to conduct a pre-licensing inspection for initial Adult Residential Facility (ARF) application. LPA Bueno identified herself to licensee Byron Simpson and informed them of the purpose of the visit.

The facility has been granted a fire clearance on 09/12/2023 by the San Bernardino County Fire Department.

The facility has been granted a fire clearance for two (2) ambulatory clients.

LPA Bueno and Licensee toured the interior and exterior of the facility. The facility has five bedrooms, three bathrooms, living room, dining room, kitchen, sitting/activity area, and backyard. The facility has no bodies of water. A covered outdoor area allows for client seating and sufficient space for outdoor activities. LPA observed that side gate was unlocked and free of obstruction. The facility has a working telephone. LPA observed charged fire extinguishers. LPA and Licensee tested smoke detectors and carbon monoxide alarms and all units were found to be in working order. The facility keeps a complete first aid kit and manual. Locked cabinets will be used for centralized medications and sharps.

The following were observed of the physical plant:

Client Bedrooms: LPA and Licensee observed all bedrooms to have the required bedding and furniture, such as, clean mattresses/linen, storage space, chairs, and lighting. Sufficient linens and towels were observed.

Client Bathrooms: LPA observed all bathrooms and fixtures are kept in sanitary conditions. LPA observed night lights were maintained in areas near bathrooms.

Dining Area and Kitchen: LPA inspected the kitchen and found dishes, glasses, and utensils were in good working order. The dining table, kitchen countertop, kitchen appliances, and floors were free of debris. Cleaning supplies are secured and sharps are locked separately. LPA observed appropriate food provisions. A sample menu was reviewed.

Activity Area and Living Room: LPA Bueno observed adequate seating in the common areas. The facility had a supply of activities and reading materials for individuals served. The facility has a sample of weekly activities.