Pre-licensing visit·June 18, 2025

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the applicant... This is a new facility application for a Residential Facility for the Elderly (RCFE) for six (6) non-ambulatory residents; one (1) of which may be a bedridden resident(s). Waiver was granted for hospice care for six (6) residents. Fire Clearance was approved on 09/27/2024. Bedridden approved in bedroom #1. At 9:30 a.m., the LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility will be following Title 22 Regulations. COMMON AREAS: The living room area is equipped with a television, and a fireplace which is operated with gas and is functional. The fireplace was covered and inaccessible to residents in care. There is a dedicated area for the posting of required documents at the entrance of the facility. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medications will be stored in a locked cabinet in the kitchen area next to the refrigerator. The residents’ and staff files will be stored and locked in a cabinet located in the living room area. LAUNDRY: There is a laundry room equipped with washer and dryer; the room is accessible through the back yard area and has a door with a lock. Detergents and cleaning supplies will be stored in a locked in this room. FRONT ENTRANCE: Front entrance will require a ramp for accessibility to the facility. Continues on LIC 809C... KITCHEN: Kitchen knives are stored locked and inaccessible in a locked kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen cleaning supplies will be stored and locked under the kitchen sink. Hot water temperature was recorded at 130.6 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. A fire extinguisher is located near the kitchen area; however, it was purchased in 2023 and was expired. BEDROOMS: There are three (3) bedrooms for residents in care, and one bedroom for staff. The Applicant will send a revised Facility Sketch to CAB to floor plan to add the Staff Bedroom. All rooms are shared rooms. Room #1 is approved for one (1) bedridden resident. All bedrooms are cleared for non-ambulatory. All bedrooms have a ramp available to exit to the outdoor area. All bedrooms were supplied with all required bedding and linens. Bedroom #3 requires additional closet and drawer space. Bedroom #1 will require additional drawer space and reposition the bed to allow for more passage to the outdoor area. Bedroom #1 requires additional drawer space. There is sufficient lighting as well as closet and drawer space available. BATHROOMS: There are three (3) full bathrooms, with shower area only and one-half bathroom. Bathrooms are equipped with toilets and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was at 130.8 degrees Fahrenheit. SURROUNDING GROUNDS/OUTDOOR AREA: The exterior passageways were clean. The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. Right passageway of the front of the property was cleared by the LAFD as the emergency exit/passageway. At the time of the visit the LPA observed one (1) ADU unit. The unit is identified by the address # 16035 and is located on the left-hand side of the front of the property/facility. The ADU unit will be separated from the main address by a fence and will not be accessible to residents in care. The Fire inspection did not include the ADU. Continues on LIC 809C... Pre-Licensing is incomplete with deficiencies to be resolved by 07/10/2025. Follow up Pre-licensure LIC809 will be generated upon resolution. · Front entrance will require a ramp for accessibility to the facility. · Hot water temperature was recorded at 130.6 degrees Fahrenheit. · A fire extinguisher is located near the kitchen area; however, it was purchased in 2023 and was expired. · The Applicant will send a revised Facility Sketch to CAB to reflect the Staff Bedroom. · Bedroom #3 requires additional closet and drawer space. Bedroom #1 will require additional drawer space and reposition the bed to allow for more passage to the outdoor area. Bedroom #1 requires additional drawer space. · Night-light added to hallway. Toilet Paper holders Purchase hygiene items. The applicant completed Component III orientation. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview was conducted and reviewed with the applicant. A copy of the report was issued.