Pre-licensing visit·January 3, 2024

On 01/03/2024 Licensing Program Analyst (LPA's) Villegas and Dabuet conducted a case management pre licensing visit to inspect corrections dated 12/18/23 during the pre licensing inspection. LPAs met with house manager Bella Lee and maintenance supervisor Juan Rossell as the purpose of the visit was explained. During the inspection visit LPA's reviewed the inspections for the following: Smoke Detectors: · Smoke detectors in room #68 is not attached properly to the ceiling. - corrected 01/03/24 Physical Plant: · Rooms #13; #19, #44, #64, #66 and #80 cluttered - corrected: 01/03/24 · Room #29, #61 (being used as storage) - corrected: 01/03/24 · Room #23, #36, #43, #46, #73 and #83 no linens - corrected: 01/03/24 · Room #23, #35, #7, #59 no furnishings - corrected: 01/03/24 · Room #30 locked no key accessibility.- corrected: 01/03/24 · Room #31 exposed hazardous chemical spray - corrected: 12/18/23 · Room#11 obstruction bed blocking access to closet - corrected: 12/18/23 · Room #35 no hot water faucet not operable - corrected: 12/27/23 · Rooms #46, #83 and #84 window screens missing. corrected: 12/28/23 · Room #39 no doorknob - corrected: 12/28/23 · Room #25 and #34 molds along the wall surfaces - corrected: 12/28/23 Pest Control: · Room #20 (roaches) - corrected: 12/28/23 · Room #21 (roaches) - corrected: 12/28/23 · Room #22 (roaches) - corrected: 12/28/23 Room #24 (roaches) - corrected: 12/28/23 Pest Control · Room #25 (roaches) - corrected: 12/28/23 · Room #34 (roaches) - corrected: 12/28/23 · Room #35 (roaches) - corrected: 12/28/23 · Room #36 (roaches) - corrected: 12/28/23 · Room #85 (roaches) - corrected: 12/28/23 Staff Records: · Fingerprint Clearances Exceptions - (S2), (S3), (S7) - corrected: 01/03/24 · Statement Acknowledging Requirement to Report Suspected Abuse of Dependent Adults and Elders - (S3), (S4), (S5), (S7) - corrected: 01/03/24 · Criminal Statement - (S3), (S7) - corrected: 01/03/24 · Health Screening - (S3) - corrected: 01/03/24 · TB Test - (S3) - corrected: 01/03/24 · Education Verification - (S2), (S3), (S5) and (S7) - corrected: 01/03/24 · Employee Rights - (S4), (S7) - corrected: 01/03/24 Resident Records: · Consent Forms - (R3), (R5) - corrected: 01/03/24 · Safeguard for Property/Valuables - (R2), (R3), and (R4) - corrected 01/04/24 · Personal Rights (R3) - corrected: 01/03/24 An exit interview was conducted with House Manager Bella Lee, and a copy of this report has been furnished to the applicant. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.