Pre-licensing visit·June 17, 2025

Licensing Program Analysts (LPAs) Cynthia Chan, Gabriela Castro, and Elena Mallett conducted an announced visit to the facility for purpose of a pre-licensing evaluation. An application was submitted to CCLD on 12/12/24 for initial license for a Residential Care Facility for the Elderly to serve the Elderly, ages 60 years and older. The requested capacity is for 6 residents, of which 5 may be non-ambulatory and 1 bedridden. LPAs used the Compliance and Regulatory Enforcement (CARE) tools to conduct the inspection. Infection Control: The licensee has an Infection Control Plan and a lead staff designated to conduct training. Facility has sufficient PPE supplies and will provide annual staff training on the infection control plan. Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. The liability insurance is maintained at $1,000,000 per occurrence and $3,000,000 total aggregate. Structure/Physical Plant: The facility is a single story home with 4 resident bedrooms, 2.5 bathrooms, living room, dining room, kitchen, storage room, and attached garage. The bathrooms have non-skid mats in the shower area and grab bars. Facility has a smoke and carbon monoxide combo detector in the living room and in the bedroom hallway. The rest of the home has interconnected smoke detectors in each bedroom. The fireplace has a secured fence and will not be in use. Knives and sharps are locked in the kitchen cabinets. Cleaning solutions are stored in a room inside the garage. There are no firearms or weapons stored at the facility. The backyard has a covered patio with a table and chairs. The facility has auditory devices located on each exit door. There is no swimming pool on the premises. Food Service : There is a sufficient food supply of 2-day perishable and at least a week of non-perishable food maintained at the facility. The kitchen is kept clean and sanitary. All the appliances are in working order. Sufficient amount of tableware, dishes, and utensils are observed. The refrigerator is maintained at 40 degrees F or below and the freezer at 0 degrees F or below. Staff and Residents files: Staff and Residents files will be maintained at the facility. Resident Rights/Information: Resident rights, Resident councils, and complaint posters are posted in a prominent area. Planned Activities : The facility has sufficient space to accommodate indoor and outdoor activities. Incidental Medical and Dental: Medications will be centrally stored in the hallway closet. The first aid kit contains all the required supplies along with the current first aid manual. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Residents with Special Health Needs: The facility accepts and retains residents with dementia and/or hospice. Component III was conducted during the visit today. The following must be corrected and submitted to LPA for licensure. * The hot water temperature is not within the required range of 105-120 degrees F. An exit interview was held, and a copy of this report was given to the applicant.