Pre-licensing visit·October 8, 2024

On 10/08/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a Pre-Licensing inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA met with Administrator, Myat Tusaw. The facility is being licensed as a change of ownership. The facility is a 4 bedroom, 2 bathroom home. A fire clearance was approved for 6 Non-Ambulatory residents for a total capacity of 6. There are 5 residents present during today's inspection. LPA reviewed residents records and observed admission agreements, medical assessments and appraisals. LPA reviewed personnel records for criminal record clearance. LPA reviewed the facility emergency disaster plan and the facility infection control plan. LPA conducted a tour of the facility and observed the following. Facility appeared clean and at a comfortable temperature. Common areas were furnished with adequate lighting. Resident bedrooms were toured and observed to have the required furnishings. Bathrooms toured and observed to be operational. Hot water measured at 112.9 degrees F. Kitchen toured and observed to be safe for food preparation. LPA observed an adequate food supply. Exterior tour conducted. All exits were open and free from obstructions. LPA observed the facility yard to be sufficient in size and appropriately equipped for outdoor use. First-Aid kit observed and contained all required items. Smoke detector and carbon monoxide detector observed to be operational during today's inspection. A fire extinguisher was observed to be last serviced on 07/16/2024. 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. Exit interview conducted. A copy of this report was provided to Administrator, Myat Tusaw, whose signature on this form confirms receipt of this document.