Pre-licensing visit·August 5, 2024

Licensing Program Analyst (LPA) J. Macias arrived announced at approximately 09:00am to conduct a pre-licensing inspection and was greeted by Applicant, Anya Balaoy. Facility currently does not have residents in care. Administrator certificate for applicant Anya Balaoy Certificate 6070875740 expires on 06/09/2026. Once obtained, applicant will submit proof of required liability insurance. The facility received a fire clearance approval on 5/8/2024 by the County of Napa Fire Prevention Division Office for six [6] non-ambulatory residents .Applicant has submitted a required infection control plan, and a required emergency & disaster plan as part of their application packet. At approximately 9:30am LPA and Applicant toured the building and grounds. The facility was found to be at a comfortable temperature. The facility consists of a single story residence with a total of 4 bedrooms, 2 full bathrooms, which one is located in the master bedroom. There was sufficient lighting throughout the facility in resident rooms, common areas, bathrooms, and hallways. No bodies of water. No firearms. All bathrooms had grab bars and non skid mats for resident use. Laundry room located in the garage, kitchen, dining room, and living room as common areas. Facility has a sufficient supply of food, perishable and non-perishable. LPA observed sufficient supply of cleaners, paper products, hygiene products, and personal protective equipment (PPE). All resident rooms are furnished per regulation with a bed, lamp, and bedside table. Cleaning supplies will be stored in a secured cabinet located underneath the kitchen sink.The facility does have emergency food supplies, and emergency supplies, to meet the "72 hour shelter in place" requirements. Hot water was measured at 119.1 and 117.1 degrees Fahrenheit, which is within regulation of 105 and 120 degrees F. All exits were unobstructed in the home. All exit doors had auditory alarms and the alarms were working properly during the inspection. Fire extinguisher was serviced and tagged as required with a date of April 29, 2024. There are six (6) smoke alarms that are dual carbon monoxide detectors and were all working appropriately. Continued on LIC809C... Continued from 809... Postings noted to be current and in compliance with regulations. There is a sign in and sign out log at the front door. All postings required were posted, and visible upon entry into the facility and during the facility tour. LPA conducted a component III orientation with Applicant Anya Balaoy. Pre-Licensing is complete and this facility has no apparent hazards to health and safety observed by the inspecting LPA, today, 8/5/2024. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulation. LPA will notify Application Unit Pre-licensing inspection is complete to proceed with the process of license. No deficiencies cited at today’s inspection. Exit interview conducted with Applicant and a copy of this report was given.