Pre-licensing visit·April 10, 2024

Licensing Program Analyst (LPA) Rosie Quiroz conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA arrived at facility was greeted and granted entry by concierge. LPA met with Jennifer Tugeon, Executive Director/Administrator and discussed purpose of the visit. An initial application to operate an Adult Residential Facility for the Elderly, age 60 years and over, for capacity of: (261) resident capacity, (51) ambulatory residents, (210) non-ambulatory residents, of which (8) eight residents are able to be bedridden in (A) building only and Hospice waiver for (20) residents was submitted to CCL on July 01, 2023. Structure: The facility is a three-story building with a connected walkway on the first floor including A and B building with 155 resident apartment style bedrooms, first floor common spaces are: kitchen, dining room, bistro, bar, library, med room, Beauty salon, movie theater, activity room, two dining-rooms, fitness room, court yard, and seven common restrooms. Second floor common spaces are: Activity room. Third floor common spaces: Relaxation room, Activity room, kitchen, dining-room, TV room, Outdoor court yard. There are 11 laundry units all together throughout all three floors. The resident’s bedrooms are spacious and will easily accommodate the resident’s furnishings. There are two courtyards and there is ample seating areas for resident throughout both courtyards. There is a front patio with seating for residents in front of the facility on both A and B buildings. Signal system: Each apartment has a call button/pull cord to request assistance and residents also utilize pendant alert system to request assistance. CONTINUED ON LIC809-C Air/Heating: Central air/heating system installed with a central panel to control entire building. Today’s facility temperature was recorded to be 72degrees Fahrenheit. Bedrooms Residents: Bedrooms are apartment style that will be private or shared. Bedrooms Staff: There is no live in staff and there is a designated staff lounge. Bathrooms: All bathrooms have a working toilet, wash basin, walk in shower/tub. There are seven common restrooms on the first floor of the building and each apartment has its own bathroom. Linens & Hygiene Supplies: Facility has an adequate supply of linens in storage unit. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food serve for one week. All day menu with substitute meals provided. Food Service: Adequate supply of seven day non-perishable and two day perishables are stored in the kitchen with surplus good stored in shed area out in the back parking lot behind the kitchen. Smoke Detectors: Smoke detectors, sprinklers and carbon monoxide alert systems are tested and maintained by an outside vendor. Fire extinguishers mounted throughout the facility charged with a date of October 03, 2023. Appliances: Residents’ apartments have small kitchen, Building B apartments have full kitchens, refrigerator, microwave, and small sink. Facility main kitchen on the first floor is equipped with ovens/ranges/microwaves, prep counters, refrigeration, freezer, grill, steam tables. Building B apartments have individual washer and dryer in each apartment. Building A has a common laundry area with operational and functional washers and dryers and a commercial washer/dryer area with functional and operational washers and dryers. Toxins: All and any toxic chemicals, cleaning solutions and disinfectants are inaccessible to residents and stored in housekeeping and maintenance supply closets. CONTINUED ON LIC809-C Water Temperature: Tested and recorded the water temperatures measuring 106.0 – 113.4 degrees Fahrenheit in resident apartments and common bathrooms in all three floors of A and B buildings. Pool: There is no pool or any body of water in this facility. Medications, First-Aid Kit & Book: Medication, first aid and book are stored in med room inaccessible to residents. First aid kits are also located in med carts and throughout the facility in common spaces. Resident & Staff Files: Records will be kept stored in file cabinet located on the first floor in the business office. Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the resident's use, commensurate with the plan of operation. Fire clearance: On October 3, 2023 Fire department granted the following: (261) resident capacity, (51) ambulatory residents, (210) non-ambulatory residents, of which (8) eight residents are able to be bedridden in (A) building only. Component III: Component III was completed with ED Turgeon during today's pre-licensing inspection. The Facility appears to be ready for licensure in the areas inspected. ED Turgeon was informed today that the facility is ready for licensure pending final approval processed by the Centralized Applications Bureau (CAB) in Sacramento. An exit interview was conducted with ED Jennifer Turgeon and a copy of this report was left at the facility.