Facility Evaluation Report

Announced prelicensing visit was made with applicants, Eulerina Koester & Eloisa Agatep. LPA Jason Lund explained the reason for the visit.

The facility will be licensed to serve up to (4) clients at any given time. This Applicant was also seeking a program through Regional Center retain up to (4) clients at any given time. There were no residents in care during today's visit.

Tour/Inspection of the facility was conducted. LPA toured/Inspected the dining area, living area, and all other areas intended for client use. LPA observed to be furnished and maintained in compliance at this time.

The Facility had a Medication closet (locked) where medication will be stored. First aid kit was observed in the Medication closet to be present and contained all required components at this time.

A tour of the (4) private resident bedrooms, was conducted. Furnishings intended for use by the residents were observed to meet the needs of the residents at this time. The Facility also had an office for staff & two staff rooms.

There are two linen closets, in the hallways, it was observed to contain a sufficient supply of towels and linens able to meet the needs of the clients at this time.

A tour of the exterior grounds was conducted. A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time. The facility has two fire extinguisher that expire on 11/25/2024 and had a working telephone.

This facility has been found to be in compliance at this time.

Both Eulerina Koester & Eloisa Agatep completed the Component 111 requirements.

An exit interview was held and a copy of this report was left.