Pre-licensing visit·April 5, 2023

Licensing Program Analyst (LPA) Lydia Martinez conducted an announced visit for the purpose of conducting a Pre-Licensing inspection. LPA met with Applicant (AP) Liza Mesdjian and a tour of the inside and outside of the facility was completed. Facility is to operate a Residential Care Facility for the Elderly (RCFE). The Application was submitted to Community Care Licensing on 11/21/2022. Facility is an existing facility, undergoing a Change of Ownership. There are 6 Non-Ambulatory Residents in care under the current license. Facility is a one story, 6 bedroom, 4 bathroom home with an attached garage that is used for storage. Facility will have hourly staff - (no live-in). Adequate seating is available in the dining room as well as the living room. Bedrooms are provided with furniture in good repair, clean linens, adequate storage space, and kept hazard free. Bathrooms were observed to be in good repair, toilets were operational, and non-skid floor mats were provided. Facility has an adequate supply of linens. Facility met the minimum 2-day perishable and 7-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to the residents in care. Facility had back-up emergency food and water supply. Smoke and carbon monoxide detectors are centrally wired and are operational. Fire Extinguishers are mounted and charged. Stove, oven, refrigerator, dishwasher, microwave, washer, and dryer are clean and operational. Toxins and disinfectants are locked and inaccessible to residents. Hot water in bathroom is within regulatory requirements. First Aid Kit contained all required items. Medication is stored in the locked hallway closet. The facility has activity supplies such as exercise, board games, Trivia, music, and bingo. Facility has a patio table and chairs with an umbrella for shade. Side exit gates are unlocked and self latching. The Component III was waived as AP is an existing Administrator for other existing facility. A Fire Clearance was granted for 5 Ambulatory and 1 non-Ambulatory Resident on 01/26/2023. Facility currently has 6 non-Ambulatory residents. LPA explained that based on Fire Clearance approved and residents residing in the facility, AP needs to submit a new LIC200 with Floor Plan to Application Specialist. LPA explained that a new Fire Clearance is needed before the facility can be ready for licensure based on inspection. LPA has contacted CAB and explained the scenario. An exit interview was conducted and a copy of this report will be sent to email on file.