Pre-licensing visit·January 13, 2022

Licensing Program Analysts (LPAs) Michael Hood and Talwinder Bains, and Licensing Program Manager (LPM) Laura Munoz, met with applicant, Sheila Bucovati, to conduct a Pre- Licensing visit. The facility has a fire clearance for 5 non-ambulatory residents and 1 bedridden resident. Applicant holds a current administrator certificate (#6003130740 with expiration date 8/19/2023). LPAs and LPM conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are five bedrooms and three bathrooms for resident use, along with one bedroom and one bathroom for staff. LPAs and LPM observed facility to be properly furnished, including appropriate bedding and lighting in bedrooms. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 110 degrees F. LPAs and LPM checked the kitchen area for the ability to prepare and store food. LPAs and LPM observed at least a 7-day nonperishable food supply at the facility. LPAs and LPM observed cleaning products and other toxins to be locked away. LPAs and LPM observed the area used for medication to be locked and inaccessible to residents. LPAs and LPM observed smoke detectors and carbon monoxide detectors at the care home are operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPAs and LPM reviewed one resident file and one staff file. LPM observed during visit that bricks outside should be secured and debris cleared, alarms should be placed on fire exits outside, backyard gate leading behind facility should be locked, lock should be placed on staff room, and locks should be placed on drawers in laundry room. LPM indicated all the above observations need to be fixed and facility will send corrections to CCLD within 7 days from today's date. ** Report continued on 809-C ** Pre-licensing passed and Component III waived. Applicant has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPAs will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.