Pre-licensing visit·March 11, 2025

Licensing Program Analyst (LPA) Cassandra Mikkelson and Cheyenne Ratajczak arrived at the facility and met with Administrator, to conduct a Pre- Licensing visit. The facility has a fire clearance for four (4) non-ambulatory residents and two (2) ambulatory residents in bedroom #1. Administrator has an active certificate (#6071118740 with expiration date 06/06/2026). LPAs conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) bedrooms and two (2) bathrooms for resident use. Bathrooms were in sanitary condition and properly maintained. LPAs observed facility has the ability to prepare and store food, to lock away cleaning products and other toxins, and lock medications to make inaccessible to residents. First aid kit is maintained and ready for emergency use. LPAs observed smoke alarm over bedroom 1 is not functioning properly and hot water temperature was 97.1 degree F. LPAs informed Applicant another pre-licensing inspection will be conducted Thursday March 13, 2025. Component III was completed. A copy of this report was provided to the facility. Exit interview conducted.