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 California Code of Regulations and Health & Safety Code. LPA was greeted by, identified themselves to, and explained the purpose of the visit to applicant Cherry Cook.

The facility fire clearance was granted on 09-20-2022 and reflects that the facility was approved for six residents in total, of which five (5) may be non-ambulatory and one (1) may be bedridden.

During today’s visit, LPA, accompanied by the applicant, toured the interior and exterior of the facility and inspected each room. 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 01/16) were provided.