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Inspection visit

Pre-licensing visit

EVERGREEN ADULT HOME CARELicense 306006251
Clean visit · 0 citations

Inspector’s narrative

What the inspector wrote

Licensing Program Analysts (LPAs) Claudia Gutierrezj and Kimberly Lyman made an announced visit to the facility for purpose of conducting a pre-licensing inspection visit to follow up on corrections identified during visit on 02/16/2023. LPAs arrived at the facility and was greeted and granted entry by designated Administrator (AD) Tamanna Rahman and House Manager Tawsique Salam. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (6) ambulatory, (0) non-ambulatory, and (0) bedridden residents was received by CCL on 10/14/2022. At 9:10 a.m. LPA toured the facility and observed the following: Five out of five stove burners on gas stove were operational. The door stopper placed on bathroom one door mid-way up scraping the paint, causing it to chip has been removed. Bathroom one is no longer missing piece of tile behind the toilet and discoloration along the baseboard has been addressed and was not observed. Tape cover measuring about 8x10 in. on one of the living room walls covering a hole has been removed and hole in the wall has been patched. Nails, bolts, and power tools previously observed laying unattended in the backyard by the side gate have been removed. LPA observed there are no broken or missing tiles on the kitchen bar or by the kitchen sink. First aid kit was observed to have scissors and all other required elements. Licensee to address the following corrections: Light switch located in the stairway has a gap between the switch cover in the wall. Baseboard along the walls upstairs is missing and there is a gap between the flooring and walls. In the entrance way to the facility fresh dry wall was observed to still be drying. All noted items will be addressed by 4/20/2023. An exit interview was conducted and a copy of this report was left at the facility.

Citations

No citations recorded on this visit

The inspector found no violations of California child care regulations during this visit.

FAQ · About this visit

Common questions about this visit

What happened during the March 20, 2023 inspection of EVERGREEN ADULT HOME CARE?

This was an other inspection of EVERGREEN ADULT HOME CARE on March 20, 2023. The inspection found no deficiencies and no citations were issued.

Were any citations issued to EVERGREEN ADULT HOME CARE on March 20, 2023?

No citations were issued during this inspection. The facility was found to be in compliance with all applicable regulations.

What type of inspection was this?

This was an other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.