Facility Evaluation Report
On 08/15/2024 at 10:30 AM Licensing Program Analysts (LPA’s) Sarah Benson arrived at the facility to conduct their scheduled pre-licensing inspection. LPA Benson met with administrator Ezekiel Contreras, Regional Director Carrie Lustig, Administrator assistant Heather Scott, Program support Andrew Creuz and explained the purpose of the visit.
Comp 3 was presented by LPA Benson to staff during the visit.
The fire marshal has approved the fire safety inspection request. The facility is licensed for 4 ambulatory residents for a total capacity of 4. This is a new facility with no residents in care at the time of the pre-licensing visit. The facility has number (4) bedrooms and number (3) bathrooms.
The inside of the facility was observed to be in good condition and repair. LPA’s observed dining area with sufficient tables and chairs for residents. LPA ‘s observed common areas. The hot water meets the requirement for licensing within a range of 105 - 120 degrees F. Food storage meets Title 22 regulation requirements. Plates, utensils, pots, and pans were in place during the inspection. Dishwasher, stove, microwave and refrigerator were all present and working. Bedrooms were observed to have furniture as required by Title 22 Regulations. All beds were made up with linens and bedspreads. Each bedroom has ample storage. Each bedroom contains sheets, pillowcases, towels and face cloths. Bathrooms were observed to be in good repair. The facility has a locked medication closet which is located in the locked medication room.Storage and lighting are adequate in the facility. Cleaning supplies and toxins are locked in janitorial rooms. Knives are locked up in the kitchen. Washers and dryers observed in place and ready for use. The facility has 2 FIRE EXTINGUISHERS fully charged fire extinguishers which were inspected by the fire marshal. LPA observed smoke alarms and carbon monoxide detectors fully functioning. There is a locked office space where client and staff files will be stored. The back yard has a nice shaded structure for residents to use.
The applicants have passed the pre-licensing portion of the application process. LPA will contact the Central Application Bureau.
No deficiencies according to CCR Title 22, Division 6. Exit Interview and copy of report was provided to the Administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction