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 representatives, Administrator Michael Francisco, Regional Director Carly Adams, and Regional Director of Program Supports Ann Marie Stanton.

The facility fire clearance was granted on 08-09-2022 and reflected that the facility was approved for four (4) clients in total, of which all may be non-ambulatory, but none may be bedridden. The fire clearance gave approval for delayed-egress exit doors, and LPA found these to be satisfactory during the visit. The facility's fire clearance did not include endorsements secured perimeter, and secured perimeter was not present. The submitted facility sketch was consistent with the current layout of the facility.

During today’s visit, LPA, accompanied by the applicant, 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 70 degrees F. Hot water temperature at taps accessible to clients were also compliant: Kitchen sink was 105.4 F, Laundry room sink was 120.0 F, Bathroom #1 sink was 117.8 F, Bathroom #2 sink was 107.1 F, and Bathroom #3 sink was 105.5 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. Kitchen Refrigerator temperature was 39 F, and Kitchen Freezer temperature was 0 F. Garage Refrigerator temperature was 38 F, and Garage Freezer temperature was -3 F. The Medications Refrigerator and the Backyard Refrigerator were 39 F.