Pre-licensing visit·July 1, 2025

On 7/1/2025 at 9:50AM, Licensing Program Analysts (LPAs) G. Luk and A. Christy conducted a Pre-licensing Inspection as a result of a change of location. LPAs met with Licensee/Applicant, Jane Bernardino. LPAs toured facility including but not limited to resident's bedrooms, bathrooms, living room, dining area, kitchen, garage, and outdoor area. LPAs observed lighting in all rooms. Hot water was measured at 106.6 degrees F in the hallway bathroom. Facility bathrooms have grab bars and non-skid mat/materials for the showers. LPAs observed facility have some non-perishable and perishable food supplies available. Licensee will purchase additional foods prior to residents moving into facility. Carbon monoxide and smoke detectors are in operating conditions. First aid kit was complete. Licensee will bring all 6 resident's furniture including bed, chair, night stand, lamp, and dresser from the other facility once the facility is licensed. Licensee will transfer the telephone land line to this facility when the facility is licensed in order to the same telephone number. The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB): 1. LPAs observed facility had fire extinguishers that were observed to be full. However, they were not serviced or have purchase receipts available. 2. LPAs observed the facility sketch for the garage did not include the storage room in the garage. Licensee will update the facility sketch. (Continue on LIC809C...) 3. LPAs observed licensee did not have a bedridden plan of operations. Licensee will also need to update the LIC610E regarding evacuation of residents who are bedridden. 4. LPAs observed facility does not have the theft and investigation policy and procedures posted. 5. LPAs observed facility did not have the fire safety plan posted. Licensee/Applicant will submit proof of corrections to CCLD on/before 7/14/2025. Exit interview conducted with Jane and a copy of this report provided.