Facility Evaluation Report

Licensing Program Analyst (LPA), Martha Arroyo conducted a pre-licensing visit to this property at 1:30pm and met with Applicant Representative, Rodolfo Ohide. This application is for a Change of Location (CHOL). The applicant has obtained fire clearance for a total capacity of six (6) non-ambulatory residents. The facility is a one-story home which will be licensed as a Residential Care Facility for the Elderly (RCFE). Currently, there are no residents residing in the facility.

Starting at 1:32pm, the LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. At 1:55pm, all hard-wired smoke alarms and carbon monoxide detector were tested and function properly. The LPA observed a fire extinguisher last serviced on 01/22/2024.

There are four (4) bedrooms for resident use; two (2) bedrooms are designated for single occupancy and two (2) bedrooms are designated for double occupancy. There is a staff bedroom for live in staff. Each bedroom is equipped with clean mattresses, pillows, and bedding. There is sufficient supply of linens, including blankets, bath towels and wash cloths. Bedrooms have sufficient lighting. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid surfaces and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in both bathrooms and measured within the range of 105 and 120 degrees Fahrenheit.

The LPA toured the kitchen area at 1:35pm. The facility has at least seven (7) day supply of non-perishable food. Appliances and all equipment appear to be clean and in good repair. Kitchen knives are stored in a locked cabinet. The kitchen has a sufficient supply of plates, cups, cookware and utensils.