Pre-licensing visit·November 3, 2021

On 11/03/2021, Licensing Program Analyst (LPA) M. Yang conducted an announced Pre-licensing / Component III Inspection. LPA introduced self, stated the purpose of the visit, and was allowed entry into the facility. LPA met with Administrator (A1), Marietta Parangalan. Administrator (A2), Innocent Idusuyi arrived later during the tour. The facility is a 5 bedroom and 2-bathroom home and fire clearance was granted for 4 Non-Ambulatory and 2 Bedridden for a total capacity of 6. There are three residents present during this inspection. LPA toured the facility with A1. Facility was free from ground obstructions and odor free. Common areas were observed to have adequate seating and lighting available. Kitchen was toured and observed to have dishes, plates, and utensils. Knives will be kept locked and secure in the kitchen cabinet. Medications will be locked in two cabinets in the kitchen. First aid kit was observed and contained all required items. Cleaning supplies and chemicals observed to be locked under kitchen sink. A fire extinguisher was observed and had a service date of 05/19/2021. Bedrooms were observed to have the required furnishing and are ready for occupancy. Hot water temperature ranged between 108 to 111 degrees F. LPA observed an extra supply of bed linens. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching. Smoke detectors and carbon monoxide were observed to be operational during this inspection. Staff records were reviewed for good health and infection control training. All residents’ records reviewed to have updated emergency contact information. Component III was conducted during today's pre-licensing visit. I have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.