Pre-licensing visit·May 30, 2025

On 05/29/25, Licensing Program Analysts (LPAs), Regina Cloyd and Jose Anguiano, conducted an announced visit to the facility for purpose of a prelicensing evaluation. On 05/30/25, Licensing Program Analysts (LPAs), Regina Cloyd and Alfonso Iniguez, conducted an announced visit to the facility for purpose of a prelicensing evaluation continuation. An application was submitted to Community Care Licensing Division (CCLD) for a change of ownership for a Residential Care Facility for the Elderly to serve the Elderly for 60 years and older. The requested capacity is for 102 residents of which 98 may be non-ambulatory and 4 may be bedridden. Any rooms on the first and second floor may be used for bedridden residents. Structure: The facility has six (6) floors which consists of: rooms 123-124, 127, 133-135, private dining, restaurant, bistro, kitchen, lobby, two (2) living rooms, lounge, laundry room, and three (3) solariums. Continue to LIC809-C. The second floor consists of: rooms 208-213, 215-216, 218-222, 224-227, activity studio, outdoor terrace, salon, hydro spa, and laundry room. The third floor (memory care) consists of: rooms 308-313, 315-316, 318-322, 324-327, living room, dining room, outdoor terrace, laundry room, kitchen, activity room, and storage. The fourth floor (memory care) consists of: rooms 408-413, 415-416, 418-422, 424-427, living room, kitchen, dining room, outdoor terrace, laundry room, activity lounge, and storage. The fifth floor consists of: rooms 505, 508-509, 511 – 515, 517-518, 520 – 522, activity studio, two (2) storages, and laundry room. The sixth floor consists of: rooms 603, 605-606, 609-612, 614-615, 617, and one storage. Bedrooms: LPAs inspected rooms 127, 135, 210, 213, 220, 225, 310, 313, 325, 410, 413, 419, 424, 505,5 15, 518, 522, 606, 610, 614, and 617 and each had bed(s), chair(s), night stand(s), chest of drawer(s)/closet space, and a lamp(s) or lights sufficient for reading. Bathrooms were inspected. Water temperature was tested in rooms 127, 135, 210, 213, 220, 225, 313, 413, 505, 515, 518, 522, and 610 and ranged between 105 to 120 degree F. Bathrooms have a working toilet, wash basin, and step-in shower. Bathrooms will accommodate non-ambulatory residents in a wheelchair. Linens & Hygiene Supplies: Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Continue to LIC809-C. Adequate supply of linen stored in the laundry room on the fourth and sixth floors and are provided to residents, if necessary. Emergency Phone Numbers, Exit Plan & Menu: The facility has a working landline and an after-hours phone line. There are fire extinguishers located on all floors. Evacuation chairs are in stairway #1 on the first, second, and fourth through sixth floors. Evacuation chairs are in stairway #2 on the fifth and sixth floors only. Food Service: Dishes, cups and flat ware are stored in the kitchen cupboards and in good repair. Knives, cutlery and other sharp kitchen utensils are stored in a secured kitchen on the first floor. The server door on the first floor contains a lock. Sharp kitchen utensils are also locked in cupboards on the third and fourth floor. Food supply adequate stored in the kitchen area and refrigerator and consists of the following: canned goods, fruit, meat, and vegetables. Emergency food supplies is located in a storage section behind the kitchen area. Smoke Detectors & Carbon Monoxide Detector: Los Angeles Fire Department conducted a fire protection equipment performance report on 08/02/2024. The test results revealed passed. Continue to LIC809-C. Appliances: The facility is equipped with central air and heat and may be individually adjusted in residents’ room. Toxins: Locked/stored outside in a box near generator and in the laundry room near the kitchen area. Medications, First-Aid Kit & Book: A first aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, and gauze, which are stored in the copy room (first floor), Med rooms (second and fourth floors) and are available for staff use but inaccessible to residents. Reading Material, Games, Equipment & Materials: In addition to a monthly activity schedule, the facility has board games, books, arts and crafts, and puzzles for the residents' use, commensurate with the plan of operation. Pool/Jacuzzi & Pets: Some residents have pets in their apartments. Continue to LIC809-C. Fire clearance: Fire Clearance with the following special conditions: rooms approved for non-ambulatory/bedridden and approval of delayed egress/secured (locked) perimeter was approved on 11/07/2024. During the facility tour, the delayed egress was tested on the third and fourth floors. Record Review Seven (7) staff records were reviewed, 7 out of 7 staff records had required criminal record clearances or criminal record exemptions. Seven (7) resident records and medications were reviewed. Infection Control Plan and Emergency Disaster Plan (LIC610E) were reviewed. Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within substantial compliance. During the prelicensing inspection certain items were observed which do not comply with applicable laws and regulations; the following items must be corrected, and proof of correction shall be submitted to the CCLD office to the attention of LPA by 06/17/2025. If additional time is required to complete noted items to correct, then the applicant will request an extension in writing prior to the due date. Some items may require a follow up inspection for verification of correction. Continue to LIC809-C. 1. During record review, LPA did not observe an Infection Control Plan (last reviewed 04/01/2023) that addressed the initial training requirements for new facility staff, ongoing training requirements for all facility staff, and a description of initial and ongoing training requirements. 2. During record review, LPA did not observe updated CCLD phone numbers, temporary shelter locations, and assignments during an emergency or disaster on the Emergency Disaster Plan (LIC610E). Also, LPA did not observe a key for identifying hospice residents on the register of residents as stated in the LIC610E lasted reviewed 05/04/2023. 3. During facility tour, LPA did not observe a current edition of a first aid manual. 4. During facility tour, LPA did not observe evacuation maps with assembly points. 5. During record review, LPA did not observe an emergency and disaster plan that addresses fire safety precautions specific to evacuation of residents who are bedridden in the event of an emergency or disaster. 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 the applicant. An exit interview was conducted, and a copy of this report has been furnished to the applicant.