Facility Evaluation Report

On 3/14/2025, Licensing Program Analyst (LPA), Janette Romero made an announced visit to conduct a pre-licensing evaluation and met with Applicant, Tuyen Nguyen. An initial application to operate an Adult Residential Facility was received by the Central Applications Bureau (CAB) on 8/2/2024. Fire clearance was granted on 10/4/2024 for one (1) non-ambulatory and three (3) ambulatory clients.

LPA toured the facility with Applicant Nguyen. During the tour, LPA observed the facility is made up of a one (1) story home with four (4) client bedrooms, two (2) bathrooms, a kitchen, dining room, living room, and attached garage. The facility has a central heating and air conditioning system installed with a central panel located in a hallway near the entrance to control entire house. Applicant Nguyen tested one (1) of the smoke alarm/carbon monoxide detectors and LPA observed it to be operational. Client bedrooms are each furnished with a bed, chair, closet storage, and two (2) or more drawers. Bathrooms have a working toilet, wash basin and have paper towels, toilet paper, and soap readily available. LPA toured the kitchen and observed the electric stove and refrigerator/freezer in working condition. The facility has a 7-day supply of non-perishable foods along with adequate seating for meals for all clients. Medications will be secured in a hallway cabinet. The facility's living room fireplace is adequately screened. Additional clean linens, blankets, pillows, and towels are stored in the garage. A washer and dryer along with cleaning solutions are secured in the locked laundry room near the garage. The backyard is fenced and there were no bodies of water observed on the premises. Indoor and outdoor pathways are free of obstructions. Let-Us-No poster, emergency phone numbers, and exit route/maps will be visibly posted near the front entrance.

During today's visit, LPA did not observe any issues or concerns. Applicant has already attended COMP III at the Riverside Regional Office. Final approval of licensure will be determined by CAB. An exit interview was conducted where a copy of this report was reviewed and provided to Applicant Nguyen.