An application was submitted to CCLD on 4/1/2020, for an initial license application for an Residential Care Facility for the Elderly, ages 59 years and above. The applicant requested for a capacity of six (6) residents. LPA arranged the teleconference visit and also was assisted by applicant Muqeet Dadabhoy during the pre-license inspection.

Structure:

Facility has (7) bedrooms (6 resident bedrooms and 1 staff room), four (4) bathrooms, in a single story house with a two (2) car attached garage. The facility is a beige stucco structure with an open floor plan which includes: living/ family, dining rooms and kitchen. The interior has recess lighting throughout. The dining area has a fireplace. The living area also includes sofas and coffee table, and a TV. The kitchen has granite counter tops with refrigerator, stove and dishwasher and dryer. The house front exterior is reinforced with stone that continues in the front of the property. During the visit, LPA noticed passageways, walkways steps and patio area free from obstruction. LPA observed a covered front porch area with seating for (2) people, and a back yard umbrella with table and four chairs. In addition, also included back yard gazebo with barbecue and table with four chairs.

Bedrooms Clients:

The facility has six (6) bedrooms for residents. Rooms #1,#2,#3,#4,#5, and #6 all have one (1) chair, one (1) bed, one (1) night stand, and one (1) table lamp. All bedrooms are equipped with ceiling lights. All rooms have dresser, which complies with the requirement of 8 cubic feet of space. All rooms also have closets for ample storage.

Continued on LIC 809C

Stove burners, oven, microwave, washer, and dryer are working. Dishwasher in kitchen properly installed and functioning. The kitchen counters also had small appliances which included: toaster, coffee maker, and microwave. There is one (1) refrigerator in the home. The refrigerator has a measured temperature of at least 45 degrees Fahrenheit for appropriate food storage. Freezer is at (45) zero degrees Fahrenheit. The residence is equipped with central AC/heating.

Toxins:

All toxins are locked/stored under the kitchen sink.

Water Temperature:

Bathroom #1 hot water temperature was tested by Licensee at 1:45 p.m. and measured at 112 degrees Fahrenheit.

Medications, First-Aid Kit & Book:

A first aid kit stored in the dinning room cabinet was inspected and has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and current first aid manual locked and inaccessible to residents in the dinning room cabinet. Also resident medications will be stored in a dining room cabinet locked and inaccessible to residents.

Resident & Staff Files:

Applicant will not be handling cash for the residents. Files for residents and staff will be stored and locked in the dining room cabinets

Reading Material, Games, Equipment & Materials:

The facility has board games, books, magazines and other recreational materials for the resident's use all stored in the living/ family room cabinet, commensurate with the plan of operation.

Pool/Jacuzzi & Pets:

There are no pets, jacuzzi or pool in property.

Continued on LIC 809C

Fire Clearance on 5/21/20 for a capacity for six (6) residents. Gate on each side of the facility property with no locks. All smoke detectors are connected, and are hot wired in the facility. Fire alarm bell in the facility. All resident bedrooms, have a door, and a sliding door to back yard. All exit doors and slide doors, in the facility, have alarms, that signals when they are opened. Throughout the facility house and garage in the ceiling is a flush fire water sprinkler system.

Component III:

An exit interview was conducted, and a copy of this report was emailed to the applicant, Muqeet Dadabhoy. Accordingly, LPA/ Campos will submit a copy of this facility evaluation report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to their application.