Facility Evaluation Report

On 05/02/2024 at 10:00 AM, Licensing Program Analyst (LPA) Avelina Martinez arrived announced to conducted a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA Martinez met with Janice Legaspi and explained the purpose of todays visit.

Facility has a fire clearance for four ambulatory clients. Janice Legaspi will be the Administrator of this facility and holds a current administrator certificate.

LPA Martinez inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. During today's pre-licensing visit, the facility was in compliance with Title 22 Regulations. The facility common areas, bedrooms, bathrooms, kitchen, and laundry room were furnished and sanitary. The exterior of the facility is clear of debris, and has a shaded sitting area for client use. The exterior emergency gate is in good repair.

Additionally, the facility has a first aid kit, and locked cabinet for medication storage. The fire extinguisher, smoke detectors, and carbon detectors were in good repair. The facility has a natural disaster plan, infection control plan, and fire drill log. The facility has no large bodies of water. The facility has employee and client files.

The applicant has passed the pre-licensing component of the application process. LPA Martinez will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. In addition, component 3 was completed during the pre-licensing inspection visit.

An exit Interview was held, and a copy this report was provided to the facility.