Pre-licensing visit·May 21, 2021

On 5/21/2021 at 9:15AM, Licensing Program Analysts (LPAs) G. Luk and L. Hall conducted an unannounced Pre-licensing Inspection. LPAs met with caregiver, Gilbert Hernandez and Licensee/Applicant, Shan Gao arrived an hour later. LPAs inspected the facility inside and out including but not limited to bedrooms, bathrooms, dining room, kitchen, living room, garage and outdoor area. The facility’s temperature was maintained at 68 degrees Fahrenheit (F). Hot water temperature was measured at 130.8 degrees F. Medications were centrally stored in a locked closet. However, LPAs found unlocked medication in refrigerator. No bodies of water observed. Disaster plan was completed on 2/1/2021. Home is clean and well ventilated with appropriate lighting. Licensee will provide LPA proof of liability insurance by 5/28/2021. Fire extinguisher was serviced on 3/1/2021. Smoke and carbon monoxide detectors were observed. First aid kit was complete. Facility has a 7-day non-perishable and 2-day perishable food supply. The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB): 1. S1 was not associated to the current facility and S4 was not fingerprint cleared. Both staff needs to be fingerprint cleared and associated to the facility as soon as possible. 2. LPAs observed frozen food had labels inside the packaging which contaminated the frozen meats. LPAs advise licensee to clean and remove all the frozen items that has labels inside the packages. 3. LPAs observed the beds in the common area near the entrance way and in the garage. LPAs also observed the bed rails, used chairs, and other items that was along the side of the facility and needs to be stored property. 4. Hot water was corrected during inspection and re-measured at 109.9 degree F. 5. Administrator locked medications in the garage refrigerator during inspection. 6. Staff locked knives, gardening tools, and paint supplies during inspection. Licensee/applicant will submit proof of corrections to CCL on/before 5/28/2020. LPAs conducted Component III with Licensee during inspection. LPAs presented Component III Power Point and discussed the regulations embodied in the presentation. Exit interview conducted and a copy of this report provided.