Facility Evaluation Report

06/06/2023 10:00 aM Licensing Program Analyst (LPA) Sarah Benson and Lauren Crocker Licensing Program Manager arrived at the facility an announced pre Licensing inspection. LPA met with Leah Aguirre Administrator and explained the purpose of the visit.

LPA Benson and the administrator toured the facility together to ensure the facility is ready for licensure. Areas toured include but are not limited to four (4) resident rooms, one Staff room, common areas, three (3 1/2) bathrooms, kitchen, storage areas and back yard.

Common area was clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Medication is locked in a locked closet. First aid kit fully stocked and ready for emergency use. Fire extinguisher fully charged. Smoke detectors are all operational exp 08-04-23. Hot water temperature measured within required Title 22 regulations of 105 degrees F and 120 degrees F. All required postings are displayed within facility. No pools/bodies of water are on premises. No firearms are on premises. Disaster plan is in place.

Exit interview conducted, a copy of the report given to Leah Aguirre Administrator.