Facility Evaluation Report

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

The facility fire clearance was granted on 01/25/2024 and reflected that the facility was approved for three (3) clients in total, of which all must be ambulatory. The facility's fire clearance did not include endorsements for delayed-egress doors or secured perimeter, and neither were present during today's visit. The submitted facility sketch was consistent with the current layout of the facility.

During today’s visit, LPA, accompanied by the applicant’s representative, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Client bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order. The facility’s ambient internal temperature was complaint at 68 degrees F. Hot water temperature at taps accessible to clients were also compliant: Kitchen sink was 110.4 F, Bathroom #1 sink was 117.1 F, and Bathroom #2 sink was 119.5 F.

The facility has enough linens, hygiene supplies, cooking and dining supplies, and perishable and non-perishable food for future client use. All kitchen appliances were in working order. Main Refrigerator temperature was 39 F, and Main Freezer temperature was 0 F. Overflow Refrigerator temperature was 40 F, and Overflow Freezer temperature was 0 F.