Facility Evaluation Report

Licensing Program Analyst (LPA) Jason Lund arrived announced at the facility to conduct a pre-licensing visit. LPA Lund met with Administrator Nicole Ell Residents and explained the reason for the visit. Census: 0

The facility is a one-story dwelling. LPA toured the facility including dining area, kitchen, family room, (4) bedrooms, (2) bathrooms, laundry (washer/dryer), garage, and yard. There is no pool present. Walls, floors, windows, and doors are in good condition. Fixtures and furniture are in good condition and there is adequate storage space. Facility central heating and air is operational and temperature is at 74.5 degrees (F). Smoke alarms, carbon monoxide detector, and fire extinguisher (May 2025) are operational. There is a locked area for centrally stored medications. The facility has 7-day nonperishable and 2-day perishable food and is compliance. Facility has adequate dishes, utensils, glasses, etc. Linen supply and personal hygiene supplies are available. Bathrooms have non-skid mats, grab bars, along with night-lights outside the entrance. Facility has sufficient space to accommodate indoor and outdoor activities.

The Pre-Licensing Inspection Tool was utilized during the course of this visit. The facility was determined to be in substantial compliance with the Health and Safety Code and the California Code of Regulations. The facility has passed the pre-licensing inspection. Component III was conducted.

An exit interview was conducted and a copy of this report was provided to Licensee Nicole Ell.