Pre-licensing visit·November 13, 2024

On 11/13/2024 at 12:00PM, Licensing Program Analysts (LPAs) A. Gomez and K Nguyen arrived unannounced to conduct Pre-Licensing inspection. LPA met with Backup Administrator, Heidi Yrreverre and explained the purpose of the visit. Applicant arrived later during visit. The facility currently has 19 residents and is approved for 4 bedridden. LPAs toured the facility with the Administrator . Physical plant is consistent with the facility sketches submitted to Centralized Application Bureau (CAB). There is no body of water. Bedrooms were observed appropriately furnished with adequate lighting. Supplies of towels, bed sheets, linens were adequate. Equipment and supplies for residents' personal hygiene were available and on site. Food supplies were observed adequate for seven days of non-perishables. Facility is equipped with refrigerator, microwave, dishwasher, washer and dryer. Storage where knives and medications is centrally stored was observed. Fire extinguisher inspected April 12, 2024. Random residents bathrooms hot water temperature was tested and measured at 111.8, 110.3, 107.4, and 113 degrees Fahrenheit. Carbon monoxide and smoke detectors were observed operational. report continues on LIC 809-C LPAs observed the following: Ripped screen in room 29 sliding door Room 20 needs Oxygen signs Food is not being stored properly in kitchen Kitchen staff has no indicators for residents with special diets Hot water dispenser that is dangerously hot to touch located in Activity/Dining Area Laundry room being used for other storage Outside gates and doors need to be locked Update all resident Update all staff files. Applicant to submit proof by December 2, 2024 showing all the 9 items are corrected. LPA will inform CAB analyst upon receipt of proof of corrections. Final review of application, and license to be granted by CAB analyst. Exit interview conducted and copy of this report provided.