Pre-licensing visit·June 4, 2025

Licensing Program Analyst (LPA) Hanna Gough conducted an announced visit to the facility for the purpose of a pre-licensing inspection. LPA arrived at the applicant facility and was greeted and granted entry. LPA met with applicant Theresa Dompreh-Mensah. An initial application to operate a Residential Care Facility for the Elderly was submitted to CCL on October 2, 2024 and was approved for four residents of which three can be non-ambulatory and one may be bedridden. The applicant facility is a one-story home with its own address and entrance behind another current facility. The applicant facility has two bedrooms, a kitchen, living room, storage room, two bathrooms, and an outdoor space for resident use. The two resident bedrooms had all the required components and furnishings with extra storage space for resident use. The bathrooms have working toilets, sinks and showers. LPA tested the water to be between 118.4-118.7 degrees Fahrenheit. The applicant facility has an extra supply of clean linens in the storage room. LPA observed required departmental postings in the main living area. LPA observed activities for resident enjoyment in the living room. LPA observed the emergency food and water supply to be located in the kitchen. LPA observed a fire extinguisher off the kitchen door charged and with a service date of December 9, 2024. LPA observed toxins and chemicals to be locked under the kitchen sink. LPA observed the centrally stored medication storage cupboard to be locked and under the kitchen counter. LPA observed the appliances to be operational. LPA observed the first aid kit in a locked kitchen cabinet that had all the required components. LPA observed the fire and carbon monoxide detectors to be operational. The fire clearance was approved on December 18, 2024. Continue on LIC 809-C LPA conducted the Component Three Orientation with applicant. Applicant was notified that the final application approval will be issued by the Centralized Application Bureau in Sacramento. An exit interview was conducted with Applicant Theresa Dompreh-Mensah and a copy of this report was provided at the time of inspection.