Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Rodgers conducted an announced Pre-Licensing and Component III visit at a Residential Care Facility for the Adults (ARF) to ensure compliance with California Code of Regulations, Title 22, Division 6 and the Health and Safety Code. LPA was greeted by, identified herself to, and explained the purpose of the visit to the Program Administrator Olayinka Ajetunmobi.

The facility fire clearance was granted on 11/27/2023 and reflected that the facility was approved for four (4) residents in total, of which two (2) may be non-ambulatory. The facility's fire clearance did include delayed-egress door or secured perimeter endorsements and 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 Program Administrator Ajetunmobi, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. The pathways were well lit and free of obstruction and slip hazards. Resident 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 compliant. Hot water temperature at taps accessible to residents were also compliant.

The facility has enough linens, hygiene supplies, cooking and dining supplies, and perishable and non-perishable food for future resident use. All kitchen appliances were in working order. Refrigerator and freezer temperatures were within regulatory range.