Pre-licensing visit·August 29, 2024

Licensing Program Analyst (LPA) Kimberly Ramirez made an announced visit and met with Licensee/Administrator Toby Miclat to conduct a Pre-Licensing evaluation. An application was submitted to Community Care Licensing Department (CCLD) on for an initial application of a Residential Care Facilities for the Elderly (RCFE) to serve adults ages 60 and over. Bedrooms#1, 2 and 3 is approved for two (2) ambulatory residents per room. Hospice waiver granted for two (2) residents. Structure: Facility is a single-story home located in a residential area consisting of three (3) bedrooms, one (1) bathroom, kitchen, dining room, living room, and detached garage, and backyard with seating and shade. Front entry has a wheelchair ramp. Bedroom Clients: Bedrooms are equipped with a bed, night stand, chair, lamp, and overhead lighting. Bathrooms: One (1) full bath equipped with working toilet, wash basins, bathtub/ walk-in shower. Linens & Hygiene Supplies: All beds had the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linens is stored in linen closets. Emergency Phone Numbers, Exit Plan: Emergency numbers are posted and readily available for review. One (1) fully charged fire extinguisher was observed. Facility has a land line telephone. Food Service: Dishes, cups, and flatware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery, and other sharp kitchen utensils were observed locked and inaccessible. Adequate food supply is stored in the kitchen and consists of the following: 2-day perishables, and 7-day non-perishables. Emergency water supply was observed. Smoke Detectors: Where observed and tested. Appliances: Refrigerator , oven, microwave, dishwasher and washer/dryer are in good condition. The residence is equipped with central heating and air conditioning. Toxins: Cleaning supplies, and toxins are locked only accessible to staff. Water Temperature: Hot water was tested in all bathrooms, and kitchen sink. Water temperature was within normal limits 105 degrees Fahrenheit (40.5 degrees C) and not more than 120 degrees Fahrenheit (48.8 degrees C). Medication, First-Aid Kit & Book: Designated centrally stored medications cabinet, and the first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. Resident & Staff Files: Designated area for files will be in locked closet. Pools/Jacuzzi/Body of Water : No bodies of water were observed. Fire Clearance : Fire clearance was approved on 4/26/2024 for six (6) ambulatory only. Component III: Component III was reviewed during inspection. Pre-Licensing is complete, and this facility has no deficiencies. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications.