Pre-licensing visit·May 17, 2023

At 9:35 am Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit with administrator. Identification of the Applicant/administrator was verified by CA driver’s license. The facility has a capacity of five (5). Application received four (4) non-ambulatory and 1-bedridden client. Purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: The common areas (kitchen, living room, and dining areas) were appropriately furnished, and lighting was adequate. The living room has a television and comfortable furniture. The facility has a variety of adequate perishable and non-perishable food supply. Appliances in the kitchen appeared to be functional. The sharps are stored and locked in drawer in kitchen. Laundry room located in garage. Washer and dryer observed to be in good repair. Toxins stored in locked garage. There is one (1) fire extinguisher: located in kitchen area attached to wall near patio door. Fire extinguisher observed to be fully charged. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at approximately 11:20 am. There is a functioning telephone/landline on the premises. An emergency exit plan/sketch is posted On living room wall next to kitchen. There are three (3) bathrooms in the facility: The hot water was tested for the bathrooms and measured at 118.6,118.6 and 117.1 °F. The bathrooms have non-skid mats, trash cans with lids and functional grab bars (Cont. from 809) There are three (3) client bedrooms: no room is designated for staff use. Client bedrooms were observed to be appropriately furnished with a bed, nightstand, dresser, and chair. Extra linen stored in clients’ room. Medications are stored in locked upper kitchen cabinet next to refrigerator. Client and staff records stored in locked metal file in kitchen. There are two (2) patio areas: one covered area with patio table and chairs for clients use and a non-covered area with sufficient seating for clients in the backyard. There is no body of water at the facility. Component III was conducted with the administrator and administrator confirmed understanding of Title 22. Facility appears to be clean and in good repair. At time of visit this facility is ready to be licensed. This report will be forwarded to the Centralized Application Bureau (CAB). Exit interview was conducted and a copy of this report was provided.