Pre-licensing visit·November 13, 2024

On 11-13-2024, Licensing Program Analyst (LPA) Seo Jeon made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA met with Applicant, Florence Mojica, who accompanied LPA for the inspection. The Applicant has submitted an application for six (6) residents (6 non ambulatory). On 07-16-2024 the Riverside County Fire Department approved a fire clearance for which the applicant has applied for. All 4 bedrooms are for non-ambulatory residents. The facility has submitted application for hospice waiver for six(6). The home is a single story structure consisting of (4) bedrooms, (3) bathrooms, lounge, kitchen, formal dining room, family room, garage, backyard with an awning. The bedrooms were observed to have bed, lighting, night stand, chest of drawers and area for sitting. The bathrooms had nonskid surface, and grab bars. There is plenty of extra linen (sheets, blankets, towels) that were observed to be in good repair. The smoke and carbon monoxide detectors were tested and found to be operable. The hot water temperature was tested and was found to be within regulatory limits measuring at 105 degrees Fahrenheit. The facility is equipped with flashlights and night lights. The facility has an emergency disaster plan and infection control plan on file. The facility has a sufficient supply of dishes, cooking and eating utensils, that were observed to be in good repair. The facility food supply was observed to be sufficient as there were 2-day supply of perishable and a 7-day supply of nonperishable food items. The facility has an emergency food and water supply. There is a fully stocked first aid kit. The passageways, and ramps/inclines are clear and free from obstruction. The home has 1 fully charged fire extinguisher. The facility does not have any known guns or ammunition stored on premises. The sharps/knives are stored in a locked cabinet in the kitchen. The medications will be kept in individual boxes that will be stored in a locked cabinet located in the kitchen. Continued on LIC809-C.... The required postings (facility sketch, resident council, theft and loss policy, personal rights, PUB475 complaint poster and the Long term Care Ombudsman poster) were observed to be posted in the lounge wall. The applicant is scheduled to complete COMP III orientation on 11-19-2024. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA determined the facility meets the operational requirements for licensure . The Pre-licensing inspection is complete, and this facility has no deficiencies. The facility has satisfied all requirements in accordance with Title 22, California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to applicant, Florence Mojica.