Facility Evaluation Report

Licensing Program Analyst (LPA) Araceli Canela arrived to conduct a pre-licensing inspection and was greeted by Applicant/Administrator, Jose Rios.

At approximately 12:30PM LPA and Applicant toured the building and grounds. The home is clean, organized, at a comfortable temperature with all exits free from obstruction. Facility is a one level residence with three bedrooms and two bathrooms. The home is made of a family room, dining room, kitchen, laundry room, backyard shed and storage. All client rooms are furnished per regulation with a bed, lamp, dresser, chair and bedside table.

The facility will have both perishable and nonperishable foods as required by Title 22 Regulations, when the first client moves in. LPA observed snacks and emergency food supply in the hallway closet. Cleaning supplies, toxins and sharps are inaccessible to clients. There was an appropriate supply of linens, hygiene products and paper products available for clients. There is a first Aid kit available. Clients will be supervised in the backyard until it is landscaped, no hazards observed.

Facility received an approved fire clearance dated May 6, 2024 for four (4) ambulatory clients by the Vallejo Fire department. LPA observed charged fire extinguishers in the main home and one located in the back storage shed. Applicant understands they must be charged and serviced yearly. Smoke detectors and carbon monoxide detectors are available and in working condition. Facility has an Infection Control plan and Emergency Disaster Plan on file. Hot water temperatures found to be within Title 22 Regulations of 105 to 120. Administrator Certificate 605847735 for Jose Rios expires 6/26/2025.

No Deficiencies or Advisories given during visit. Pre-Licensing inspection is complete. Component III was conducted with Applicant.

LPA will then submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicant of Status