Facility Evaluation Report

Announced Prelicensing visit made out to this facility by LPA Charlie Yang on 02/07/2022. This LPA was met by the Applicant, Kuljit Kaur, who was briefly interviewed prior to the facility walk through.

This Applicant is seeking licensure for a 6-bed Adult Residential Facility to accept and retain ambulatory only residents at this time. It was also learned that this Applicant is in the process of vendorization through Valley Mountain Regional Center for a level 4I care home.

A tour of the living room, dining room, and all other interior areas intended for use by the residents was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

A tour of the kitchen was conducted. Food storage for 2-day perishable supply was observed to be sufficient and able to meet the needs of the residents at this time. A review of the nonperishable food supply was observed to be sufficient and able to meet the needs of the residents at this time.

Cabinets and drawers were opened and reviewed for adequate plates, utensils, and cook ware at this time.

Fire extinguisher, located in the kitchen area, was reviewed for annual purchase date or inspection date.

A tour of the facility resident rooms and restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Hot water temperatures were taken in the resident restrooms to make sure that they were within the allowed range of 105-120 degrees.

A review of the medication cabinet was conducted. First aid kit was observed to be present and contained all of the required components at this time.

A review of the storage cabinet housing cleaning agents and supplies was observed to be locked and made inaccessible to the residents at this time.

A tour of laundry area was conducted. It was observed that there were two laundry areas at this time. Laundry detergents and bleach were observed to be locked and made inaccessible at this time.