Facility Evaluation Report

Licensing Program Analyst (LPA) Tiffany Holmes 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 herself to, and explained the purpose of the visit to the applicant’s representatives, Abdiaziz Hussein, Administrator.

The facility fire clearance was granted on 08/16/2024 and reflected that the facility was approved for four (4) clients in total, of which may be ambulatory with one (1) may be bedridden/non ambulatory in bedroom 4 only. 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. Toilets and sinks were in working order. The facility’s ambient internal temperature was complaint at 68 degrees F. Hot water temperature in bathrooms that were accessible to clients were also compliant reading at 113.2 F.

The facility has enough perishable and non-perishable food for future client use. All kitchen appliances were in working order. Refrigerator temperature and freezer temperature was adequate.