Pre-licensing visit·March 19, 2024

Licensing Program Analyst (LPA) Mora conducted an announced Pre-Licensing visit. LPA met with Jannette Rodriguez and Eddie Alvarez and explained the reason for the visit. An initial application was submitted to Community Care Licensing Department (CCLD) for a Residential Care For Elderly facility to serve four (4) ambulatory residents, of which one (1) may be non-ambulatory in the age range of 60 and over. The facility is in a residential area and it is a one story family home. A tour of the single-story facility included the 4 client bedrooms, 2 bathrooms, living room, dining area, kitchen, activity area, laundry area, detached garage, front yard and backyard. LPA conducted the tour with Jannette Rodriguez and Eddie Alvarez and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen. Sharps and cleaning solutions are kept locked under the kitchen sink. Client and staff files will be kept in cabinet near the kitchen. Medications will be locked in a kitchen cabinet. The First Aid kit is kept locked in the laundry area and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway cabinets. Dining and living room have sufficient lighting and sitting area. All bedrooms have all required furniture, lighting, and bedding. All showers were observed with non-skid carpets. The water temperature was tested in both bathrooms and measured at 105.2 degrees F, which is within the required 105-120 degrees F. Fire extinguishers were observed in the kitchen and hallway and it is fully charged. Smoke detectors were observed throughout the facility and in each room and were operable during the visit. A carbon monoxide was observed in the kitchen and was operable during the visit. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction. No outstanding or pending items were observed by the LPA requiring additional pre-licensing visits. LPA will notify the assigned Centralized Applications Bureau (CAB) Analyst of the completed pre-licensing facility evaluation visit conducted, which included the Component III Orientation. Exit interview conducted and a copy of this report was provided to the licensee.