Pre-licensing visit·January 5, 2026

On 01/05/2025, Licensing Program Analyst (LPA) Daiquiri Boyd made an scheduled visit to the facility for the purpose of conducting a Pre-Licensing Inspection and Comp III. LPA was greeted by Licensee/Administrator(AD) Ramachandra Bangalore. This facility is approximately 6,000 square feet and has 20 resident rooms, kitchen, dining room, an activity room, outdoor courtyard and outdoor patio, beauty shop, living room area, and laundry room. There are "Jack and Jill" bathrooms in all resident bedrooms, containing a toilet and a sink. There are 2 separate shower rooms that are shared by all residents. LPA began the tour by entering through the entrance doors off of the parking lot. There is a front door that chimes when it is opened, but is not locked during daytime hours. AD explained that the front door is locked to anyone trying to enter the facility during the night, but is not locked to anyone leaving. Facility employs 14 caregiver staff, 2 of those are night staff. (continued on the next page) Smoke detectors are located throughout the facility and found to be in working order and the sprinkler system was tested by A & B Sprinklers and Fire on a quarterly basis. Four Carbon Monoxide detectors found to be in working order. The Fire Extinguisher was serviced on 10/01/2025. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Resident rooms are found to be in good repair and contained required furnishings, and lighting. The resident bathrooms were found to be clean and in good repair. Shower rooms were observed to be in good repair. The kitchen was observed to have a supply of dishes, plates, utensils and cooking items. Food storage areas are clear and appropriate for food preparation. Cleaning supplies, chemicals, and sharps/knives are locked as required. Appliances were found to be in working order. LPA observed the required food supply. Resident medications are stored in a designated locking closet near the kitchen and dining area. The First Aid kit contains all required items. Doors and passageways are unobstructed throughout the inside and outside of the facility. Outside of the facility was toured and there is space with covered seating for the use of residents. Required postings are placed on a bulleting board. LPA observed the Emergency and Disaster Plan, Infection Control Plan and client roster. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued. An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receipt.