Facility Evaluation Report

Licensing Program Analyst (LPAs) Albert Johnson arrived announced for a pre-licensing inspection. There are no residents in care as facility license is pending.

LPA toured the interior and exterior of the facility including the common areas, bathrooms, residents room and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting. . LPA observed the smoke/monoxide alarms to be in working order, and the fire extinguisher to have been serviced.

LPA observed a complete first aid kit. Land telephone service number is to be active today. LPA observed locked cabinet where resident files and medications will be stored. LPA measured hot water at 111.5*F in a resident bathroom and the inside temperature measured 76*F.

LPA observed books, puzzles and games on site. LPA observed (1) unlocked gates and a ramp on the side of walk way.

Based on today's inspection, the pre-licensing is completed /passed. LPA completed the COMP III. Applicant has satisfied all requirements in accordance to Title 22, California Code of Regulations. CAB will be notified accordingly.

Exit Interview and copy of report provided