Facility Evaluation Report

Licensing Program Analysts (LPA) Joanne Roadilla and Steve Chang conducted a pre-licensing inspection today for a change of ownership. LPA met with licensee Patrick Laurel and home Administrator (ADM) Christine Lee. The home currently has 5 residents.

At around 2:00pm, LPAs toured the facility inside and out. The facility is equipped with smoke and carbon monoxide detectors. Fire extinguisher observed in the home which were all serviced on 06/20/21. The kitchen, dining and living room were observed in good repair.

Resident bedrooms were observed in good repair, furnished, with clean linens and adequate lighting. Bathrooms were observed clean and equipped with grab bars. The water temperature in the kitchen was measured at 103.8 degrees F. Centrally stored medication cabinet with first aid kit was observed locked. 2-day perishable and 7-day non-perishable food were observed in the kitchen. All outdoor and indoor passageways were observed clear and free of obstruction. The backyard was inspected, no bodies of water observed.

LPAs reviewed 5 resident files and 4 staff files. Facility staff are fingerprint cleared and associated to the facility. Resident files all consist of Admission Agreement, Appraisal Needs and Services Plans and Functional Capability Assessment forms.

Component III orientation was completed with licensee. No issues noted during the pre-licensing tele-inspection. The physical plant is approved pending the completion of Centralized Application Bureau (CAB) review of the facility application. Exit interview conducted with and copy of report provided to Patrick Laurel and Christine Lee.