Pre-licensing visit·June 23, 2023

Licensing Program Analyst (LPA) Lydia Martinez conducted an announced Pre-Licensing visit and was greeted and granted entry into the facility by Designated Administrator Samuel Faye. The initial Application to operate an Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 04/12/2023 for a capacity of 110 non-Ambulatory residents, of which 12 may be bedridden. A tour of the physical plant was conducted inside and out with Mr. Faye. The following was observed: No resident were present during today's visit as facility is a brand new facility. Structure: The facility is designed as an apartment Assisted Living and Memory Care with two floors with a restaurant style kitchen/food prep area, Lobby, Activity Room/Art Studio, Bistro, Medication Room, Movie Theater, Fitness Room, Beauty Salon, Dining Room, and a Courtyard with patio tables and chairs. The resident’s bedrooms are spacious and will easily accommodate the residents furnishings. Air/Heating: Central air/heating system installed with a central panel to control each designated section of building. Resident’s bedroom have individual central panel to control entire apartment. Bedrooms Residents: 58 in Assisted Living and 22 in Memory Care for total of 110 non-Ambulatory residents. All bedrooms are equipped with an attached bathroom. Signal System: Call system is in place in each apartment in Assisted Living and Memory Care. Was tested and found to be operational. Bedrooms Staff: No bedroom designated for awake-staff. Bathrooms: All bathrooms have a working toilet, wash basin, grab bars and walk-in shower. Linens & Hygiene Supplies: Adequate supply of new linen available in storage space of facility. Ombudsman Poster, Personal Rights and See Something Say Something Poster: Ombudsman poster, Personal Rights and See Something Say Something posters were posted. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review and Emergency Disaster Plan with means of exiting and emergency phone numbers listed. Evacuation Chairs are in place. Menus posted and available. Menus prepared one week prior and listed for food served for one week. Generator: O bserved during the visit. Food Service: Adequate supply of 7-day non-perishable and 2-day perishables will be available at all times when residents present. Smoke Detectors: Smoke detectors and carbon monoxide alert systems are hardwired and tested by outside vendor. Appliances: Residents apartment are equipped with a refrigerator/freezer and microwave. Toxins: Several locked closets for storage of toxins and cleaning equipment. Water Temperature: Is within regulatory requirements of 105 and 120 degrees F. Medications, First-Aid Kit & Book: Medication, First Aid kit, and First Aid book stored in medication room, inaccessible to residents. Resident & Staff Files : Records will be kept in business office. Pool/Jacuzzi & Pets: No pool or bodies of water observed. Pets will be allowed under 30 lbs. Fire Extinguisher: Mounted in hallways and common areas. Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the residents use, commensurate with the Plan of Operation. Fire clearance: Granted on 06/07/2023 for 98 non-Ambulatory, and 12 bedridden residents. The following special conditions shown on the approved floor plan: Approved delayed egress and bedridden occupants. Bedridden not to exceed 12 for entire building. Component III: Component III is waived as Applicant is an existing Administrator. Designated Administrator was notified that the final application approval will be issued by CAB in Sacramento. The facility meets Title 22 requirements and is ready to be licensed based on LPA's inspection. Exit interview was conducted and a copy of this report will be sent to email on file.