Pre-licensing visit·February 9, 2024

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection to follow-up on corrections identified during visit on 2/01/2024. LPA arrived at the facility and was greeted and granted entry by designated Administrator (AD) Mary Han. An application to operate an Residential Care Facility for the Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by CCL on 9/27/2023. At 9:00 a.m. LPA toured the facility and observed the following: Water temperature has been adjusted and tested at 120.3 degrees F. See Something, Say Something poster (PUB 475) is regulation size of 20” x 26” and was observed to be posted in the main entryway of the facility. Facility has a shaded seating in the backyard that is equipped for outdoor use. Hand soap supply was observed to be available in residents’ bathroom. Fireplace was observed to be screened. Facility’s policy concerning family visits and other communication with residents was available for review and was observed to be accessible to residents and families. First aid kit was observed to have a thermometer. LPA conducted an inspection of the garage and observed it is being used as facility storage. Component III : Conducted during this inspection, information provided about how to operate the facility within compliance and reporting requirements. (Cont. LIC809-C) The facility is ready to be licensed. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau (CAB) in Sacramento. An exit interview was conducted, and a copy of this report was left at the facility.