Facility Evaluation Report

Licensing Program Analyst (LPA) Alyssa Ramirez conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of California Code of Regulations and Health & Safety Code. LPA was greeted by, identified themselves to, and explained the purpose of the visit to applicant Bertha Rodriguez.

The facility fire clearance was granted and reflects that the facility was approved for 6 residents in total, of which all six (6) must be ambulatory.

During today’s visit, LPA, there are items which must be corrected for the facility to comply with regulation(s). The applicant did not pass the pre-licensing inspection, and a return visit will be required.

An exit interview was conducted with the applicant, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.