Pre-licensing visit·February 11, 2025

Licensing Program Analyst (LPA) Cassandra Mikkelson arrived at the facility and met with Administrator, Vanla Peters, to conduct a Pre- Licensing visit. The facility has a fire clearance for six (6) non-ambulatory residents. Administrator has an active certificate (#7027076740 with expiration date 12/01/2025). LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) bedrooms and one (1) bathroom for resident use. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 116.4 degrees F. LPA 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. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit and fire extinguishers are maintained and ready for emergency use. Component III was completed with Licensee. Application is pending and LPA 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.