Facility Evaluation Report

Licensing Program Analysts (LPA) Anna Bueno conducted an announced pre-licensing inspection of the facility. LPA met with Licensees Ahmad Hazameh and Ahmad Salamah who were informed of the purpose of today's visit. There are currently no residents in care.

Application : The application is for a Residential Care Facility for the Elderly. Fire clearance has been granted for six (6) ambulatory residents. Fire inspection was on conducted on April 25,2023 by the Fontana Fire Prevention Office.

Buildings and Grounds: The home is composed of five (5) resident bedrooms -one of which will be utilized as the staff office, three (3) bathrooms -two of which are dedicated for resident use, a laundry area, a living room, a kitchen and dining area, and a backyard patio. LPA and Licensees toured the interior and exterior of the facility. This facility has no bodies of water. A shaded backyard patio area is available for residents. LPA and Licensees observed that side gate is unlocked and free of obstruction. The facility has a working telephone for residents use. LPA and Licensees observed charged fire extinguishers and, Licensee tested smoke alarms and carbon monoxide detectors that were operable. The facility had a complete first aid kit and manual.

Storage and Supplies: Activities were observed to be available in the living area and appear to be a sufficient amount for the requested census. Medications will be kept secured in a medication cart kept in the staff office. A standing locked cabinet is available for facility files and resident files. The first aid kit was observed to be available and complete. Linens, and equipment are all in good repair and sufficient for approved census.

Food Service and Laundry: Utensils and dishware are sufficient for the requested capacity. The refrigerator and stove are in working order. There is a secured storage for sharps, and cleaning supplies and toxins were locked in a closet.