Facility Evaluation Report

Licensing Program Analysts (LPAs) Yang and Hiratsuka arrived to conduct an unannounced annual visit.

During today's inspection, LPAs observed clients participating in activities in the common area. This facility opens to the main common area. There is an office to the left of the main entrance. There are two client restrooms and one staff restroom. There is a separate building on the property used for meal prep. This facility has a kitchen in the back.

LPAs conducted file review and observed the required documents present.

The following shall be updated and submitted to Community Care Licensing Division by the end of the month

-LIC 308 designation of administrative responsibility

-LIC 500 facility personnel or staff schedule