Pre-licensing visit·February 12, 2024

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA arrived at the facility and was greeted and granted entry by Diana Navarro, Vice President of Operations and brought to the office of the Administrator Robert Johnston. An application to operate a Residential Care Facility for the ElderLY (RCFE) for (120) capacity, (0) ambulatory, (112) non-ambulatory, and (8) bedridden residents was received by CCL on 8/7/2023. Structure - The four-story facility houses Assisted Living (AL) and Memory Care (MC) apartments. The lower level houses the parking garage, 2 common bathrooms, Activities Room, Theater, Salon, Exercise Room, commercial laundry room and Employee offices. The 1st floor houses 21 AL apartments, 2 common bathrooms, Living Room, Club Room, Private Dining Room, Outdoor Patio, Courtyard, Cafe, Kitchen, Common Dining Room, laundry room, loading dock, Reception and employee offices. The 2nd floor houses 9 AL apartments, 31 MC apartments, 1 MC common bathroom, MC Dining Room, MC Living Room, MC Activity Space, MC Salon, 2 MC Patios, AL laundry Room, MC Laundry Room, Chart Room, Med Room, Satellite Kitchen and employee offices. The 3rd floor houses 40 AL apartments, Health Services Office, laundry Room, Chart Room and Med Room. LPA observed the facility to be clean and sanitary. Resident Apartments/Bedrooms/Hot Water - LPA toured 3 model apartments. All apartments have private bathrooms. LPA measured hot water in rooms on each floor. Hot water measured was observed to be between 105 and 120 degrees Fahrenheit. LPA observed all windows were screened. Medications, Files, First-Aid Kit will all be stored in Chart Rooms and Med Rooms. Activities - The facility has an exercise room, a theater, salons, as well as activity rooms equipped with board games, art supplies and more for resident use. Kitchen/Food Service/Emergency Food & Water/Toxins - There is a 2-day supply perishable food and a 7-day supply of non-perishable food on hand. Emergency food supply is located in the kitchen. Emergency water is located in 55-gallon drums. There are 3 on each floor, LPA observed a walk-in refrigerator, a walk-in freezer, a walk-in pantry and noted the kitchen has working appliances and can be locked from all entrances. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored and locked in the kitchen and laundry rooms. LPA noted the toxins stored in the kitchen are stored separate from food and food-handling items. The Fire Clearance, including the smoke/carbon monoxide detectors/sprinkler system was approved by a fire inspector of Newport Beach Fire Department on 12/21/2023. All fire extinguishers are fully charged. The service tags indicates they were last serviced on 7/28/2023. Emergency Phone Numbers, Exit Plan, Activity Calendar & Menu are all posted and available for review. Component III was reviewed and provided via PDF. Comp III provides a general overview of how to maintain compliance in accordance with regulations. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. Exit interview was conducted and a copy of this report and Component III presentation were provided to designated AD.