Facility Evaluation Report

Announced pre-licensing visit was with applicant, Chloe Ashiegbu. 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. Census 0

LPA Lund toured 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 locked in the kitchen where medication will be stored. First aid kit was observed in the hall way 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. The facility also had two restrooms for clients in care and one restroom for staff.

There is one linen closets, in the hallway, 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 one fire extinguisher that expires on 10/28/2025 and had a working telephone. This facility has been found to be in compliance at this time.

Applicant, Chloe Ashiegbu completed the Component 111 requirements.