Facility Evaluation Report

Licensing Program Analysts (LPAs) Yang and Hiratsuka conducted this unannounced annual visit. LPAs conducted a tour with Caregiver.

Tour of the facility, the main entrance opens to the main common area that includes sitting, dining, and kitchen. To the left of the main common area is a hallway leading to the three shared resident rooms and one full common bathroom and the largest room has a full bathroom. To the right of the main entrance is a sitting area. Next to the dining room is the laundry room that leads to a staff area that has two staff rooms and a staff bathroom from the staff area. There is a door leading to the backyard from the dining room. There is a detached garage.

The following shall be updated and submitted to Community Care Licensing Division by 01/31/2025:

-LIC 500 Facility personnel or staff schedule

-LIC 308 Designation of Administrative Responsibility

Inspection tool completed and no deficiencies cited.