Pre-licensing visit·February 7, 2023

At 10:00am, Licensing Program Analyst (LPA) Angela Panushkina conducted an announced Pre-Licensing visit to this facility and met with the Administrator. This is an initial application. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. Today’s site visit consisted of LPA touring the physical plant inside and outside and observed the following: The facility has dual carbon monoxide and smoke alarm system. There are two (2) fire extinguishers, with a date of purchase of 12/17/2022. There will be a functioning telephone on the premises. An emergency exit plan/sketch is posted on the hallway wall with other posting requirements. There are five (5) bedrooms designated for resident use. Resident bedrooms were observed to be appropriately furnished. The facility will have an awake staff. The common areas (living room, kitchen, and dining areas) were appropriately furnished, and lighting was adequate. The living room has a television and comfortable furniture. Resident, staff records and medication will be stored in a locked closet near the kitchen. The first aid kit is readily available. There are two (2) bathrooms in the facility. Bathrooms have non-skid mats and appropriate grab bars. Trash cans were observed to have closed tight fitting lids. The kitchen knives are stored in a locked drawer. The kitchen cleaning supplies are stored in a locked cabinet near the stove. Laundry detergents, cleaning supplies and other toxins are stored in the designated laundry room, which leads to the garage. The necessary precautions have been made to the facility to safely house dementia residents such as auditory alarms on all doors and locked areas for centrally stored medications. Facility appears to be clean and in good repair. Appliances in the kitchen appeared to be functional. Continue on LIC9099-C There will be a sitting area in the backyard for residents to conduct outdoor activities. There is a swimming pool, that was observed to have a five foot fence surrounding its parameters, and a locked gate at entry. The outdoor, front and back yards were free of any obstruction. Component III was conducted with applicant. No deficiencies issued with this report. This report will be forwarded to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. Exit interview was conducted. A copy of this report was signed and delivered.