Pre-licensing visit·May 15, 2024

Licensing Program Analyst (LPA) Rose Ruppert made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA met with Administrator (AD) Angelina Teves and Kian Pascual. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by our agency on April 11, 2024 for a total capacity of six; four non ambulatory, one bedridden and one ambulatory. The facility is approved for four residents on hospice. The facility is a two story home with four client bedrooms, two bathrooms, a dining room, a kitchen, a living area, and an attached two car garage. The upstairs is inaccessible to residents and is for live-in care staff. All exiting doors had alarm notifications. There is a backyard exit gate on the side of the house that is unlocked but does not self-latch. There is a swimming pool that is fenced and inaccessible. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. LPA observed the See Something, Say Something poster (PUB 475), Personal Rights, Visiting Hours and Emergency Disaster Plan in the facility mounted on the wall in the kitchen area. Client bedrooms had the required furnishings. LPA observed all beds had linens and blankets but did not observe night lights in hallways to common bathrooms. All toxic chemicals, cleaning solutions, and disinfectants are inaccessible to residents and will be stored and locked underneath the kitchen sink. Medications will be stored in a locked cabinet. The first aid kit is stored in the garage and has all the required elements. Reading materials and games were observed in the living room with a phone for client use. A supply of seven day of non-perishable food was observed and will be maintained on hand. AD will provide two day perishables upon receipt of residents in care. Smoke detectors and carbon monoxide detectors tested operational. Gas burner stove, dishwasher, refrigerator, microwave, washer, and dryer are operational. AD waived the Component Three Orientation since she has two other licensed facilities. AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted and a copy of this report and Technical Advisory was provided to Licensee.