Facility Evaluation Report

Licensing Program Analyst (LPA) Nakagawa arrived unannounced to conduct a Case Management - Other Visit and met with House Manager Anitha Maluw. The purpose of the visit is to check on the administration of the facility during the transition of License.

LPA discussed the requirements for an Administrator and provided the House Manager with a list of documents required. House Manager has a current Administrator's Certificate #6077698740, exp. 9/2/27. LPA also requested an updated copy of the resident roster, the LIC500 and staff roster.

LPA did a tour of the facility and found an adequate supply of perishable and non-perishable foods, as required. The temperature of the house was 75 degrees F and the water temperature was 106.4 degrees F. Bathrooms were clean and sanitary. Residents were clean and dressed appropriately. Rooms were furnished as per regulation. Common areas were clean and comfortable, and decorated for the hoildays.

Exit interview conducted with Anitha Maluw.