Pre-licensing visit·October 23, 2025

Licensing Program Analyst (LPA) Katie Brown arrived to conduct the Pre-Licensing Inspecting. LPA met with Camalah Kopacz and Administrator (AD) Ryan Stein. This is a Change of Ownership. LPA began the tour by entering the single story 6-bedroom, 3-bathroom home. This facility has fire clearance for 6 non-ambulatory residents – the Master bedroom and bathroom are designated for care staff. Required postings were hung and visible to all. Common areas throughout the home were well lit with clear walkways and the flooring was intact. LPA observed required supply of, cleaning, disinfecting supplies and paper products. LPA observed resident rooms to find required furniture, bed linens, lighting, towels and personal hygiene/grooming products. The bathrooms are clean, with grab bars and skid resistive mats in good repair. Smoke and Carbon Monoxide detectors were tested and found to be I working order. The Fire Extinguishers were serviced 3/20/25 by Jorgensen Fire Co. The kitchen was observed to have a supply of dishes, plates, utensils, and cooking items. Cleaning supplies, chemicals, sharps and knives are stored and appropriately locked. LPA observed the required food supply, including separate emergency food, water and supplies. Resident medications will be stored in a hallway closet. The First aid kit contained the required items. Doors and passageways are unobstructed throughout the home. Outside of the facility was toured. There is a covered seating area, and a self-releasing gate found to be working properly. The facility phone number is (559) 400-8473. COMP III was not completed today. Page 2 - The following requirements have not been met. AD will correct the identified requirements and contact LPA to schedule a subsequent Pre-Licensing visit: · Kitchen drawer left of oven – fell out upon opening – repair · Master Bathroom – Window caulking replacement, wall cleaning, shower mildew removal, cleaning and re-caulking, sink damage repair or replacement · Main resident bathroom – re-caulking at base of bathtub and shower, baseboard replacement, water damage repair in shower, wall repair at towel bar · Half-Bath – Floor and baseboard replacement · Removal of the dog run (east side of house) Patio table and seating needed An exit interview was conducted and this report was signed by AD. This report was emailed to Camalah Kopacz and Administrator (AD) Ryan Stein.