Facility Evaluation Report

Licensing Program Anaylst (LPA) Janira Arreola conducted an announced Prelicensing Visit. LPA was granted entry by and met with, Applicant, Katy Hoslar who was informed of the purpose of the visit.

The applicant is seeking a change in facility type for an Adult Residential Facility. The facility is a (2) story home with resident rooms totaling (3) bedrooms and (2) bathrooms. Bedrooms have been approved by the local fire jurisdiction for (6) ambulatory residents. There are no bodies of water, weapons or fire arms kept at the facility.

LPA observed the kitchen had cooking supplies and equipment in good working condition. The facility meets the required food supply. The knifes and cleaning supplies will be kept locked. The knifes are kept locked in the kitchen with cleaning supplies kept in a separate entry way closet. The medications will be kept in a locked cart in the staff office. The outdoor area was observed to be free of hazards and had (2) exit paths. There are activity supplies for residents to engage in. LPA observed the resident bedrooms had the required furniture and the bathrooms have grab bars and hygiene supplies for residents. The hot water temperature was recorded at 108.5F and the carbon monoxide and smoke alarms are in working condition. The laundry room had equipment in good working condition. There is a supply of linens and towels for future residents. The facility has electronic staff and resident records that can be accessed on site. Required postings are found in the hallways. Emergency supplies are kept in the staff office and PPE supplies were kept an upstairs supply room. The land line is operational at (760) 216-6286.

There are no objections for the applicant to proceed in the prelicensing process. An exit interview was conducted where this report was reviewed and provided to the applicant.