Pre-licensing visit·March 23, 2022

On 03/23/22, Licensing Program Analyst (LPA) M. Yang conducted an announced Pre-licensing and Component III inspection. LPA introduced self, stated the purpose of the visit, and was granted entry into the facility. LPA met with caregiver Marietta (Mayette) Padua. Licensee Cherry Garcia was called and arrived shortly. LPA toured the facility with Licensee. There are 5 residents present during this inspection. The facility is 5 bedrooms and 3 bathrooms home. Fire clearance was granted for 6 Non-Ambulatory for total of 6 capacity. Facility temperature is set to 77 degrees F. Common areas were furnished and had adequate seating and lighting available. Kitchen was toured and observed to have dishes, plate, and utensils. LPA observed a 2 day supply of perishable foods and a 7 day supply of non-perishable foods. Knives were observed to be locked and secure in a lock box in kitchen pantry. Medications were kept in kitchen cabinet locked and inaccessible to residents in care. First aid kit was observed and contained all required items. A fire extinguisher was observed and has a service date of 03/23/22. All Bedrooms were observed to have required furnishings. Hot water temperature ranged between 112.8 to 115.3 degrees F in bathroom 1 and 108.3 degrees F in bathroom in the shared bedroom. LPA observed an extra supply of bed linens and personal hygiene products. Cleaning supplies and chemicals were observed to be in a locked cabinet in the garage. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-closing and self-latching. Smoke detectors and carbon monoxide detectors were observed to be operational during this inspection. All resident records were reviewed. LPA observed resident Admission Agreements and Physician Reports. Staff records were reviewed to have a criminal record clearance. 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.