Facility Evaluation Report

Licensing Program Analysts (LPAs) Michael Bilger and Noel Wolf Petersen conducted an announced pre-licensing visit to this facility on 4/10/2025 at 10:30am and was met by the Applicant, Imani Warren. Brief interview was conducted with the Applicant.

It was learned that this facility will be licensed as an adult residential facility to serve up to 4 ambulatory clients and 0 non-ambulatory client. . This Applicant is also seeking vendorization from local regional center. There were no clients present during today's pre-licensing visit.

Tour of the facility was conducted. Dining area, living area, and all other areas intended for resident use were toured and observed to be furnished and maintained in compliance at this time. LPA observed no obstruction of emergency exits. Fire extinguisher in place at kitchen area and fully charged with last inspection date of 1/14/2025. Facility map indicating emergency exits posted in appropriate locations. Complaint poster and resident rights posted. Kitchen area was toured. Cabinets and drawers were opened and reviewed by this LPA along with the Applicant. Food supply was sufficient in quantities. Medication cabinet, located in the Kitchen was toured. First aid kit was observed to be present and contained all required components at this time. A tour of the resident bedrooms was conducted. Furnishings and furniture intended for use by the clients were observed to be sufficient and able to meet the needs of the clients at this time.

A tour of the resident bathrooms was conducted. Hot water temperatures were taken and measured 117.5 degrees F*, within the allowed range of 105-120 degrees F*. Linen closet, located in the hallway, was observed to contain a sufficient supply of towels and linens able to meet the needs of the residents at this time.

A tour of the exterior grounds was conducted.