Pre-licensing visit·October 6, 2022

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced on 10/06/2022 to conduct a prelicensing inspection. LPA met with applicant Charmaine Mendaros. This prelicensing is for an initial application. There are no residents currently in care. Facility has a fire clearance for one ambulatory, two non ambulatory, and three bedridden residents. LPA toured building and grounds which were clean and in good repair. Facility has a total of five bedrooms, one of which is shared. Bathrooms were equipped with necessary grab bars and non-slip mats. Licensee plans to make modifications to bathroom. Licensure will be dependent on modifications. LPA observed necessary furniture except for chairs. Licensee plans to add chairs to resident bedrooms. Facility was a comfortable temperature. Exits and walkways were free from obstructions. Working auditory devices were observed on the doors. LPA and applicant discussed regulations concerning perishable and non-perishable food. There are locked storage units in the garage available for toxins. Medications will be stored in locked cabinets in the living room. Facility has a central storage area for resident and staff records. Operating smoke and carbon monoxide detectors were observed throughout the facility. Building has had a sprinkler system installed. Applicant will obtain copies of LTCO and CCL complaint postings. Comp III performed with applicant. Exit interview conducted with applicant and a copy of this report emailed. LPA will notify application unit to proceed with licensing pending modifications to bathroom. Applicant will submit pictures to LPA.