Pre-licensing visit·January 6, 2025

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 Lorenzi Nunez, Applicant, who accompanied LPA for the inspection. The Applicant has submitted an application for 6 residents (6 non ambulatory). On 8-20-2024, the Riverside County Fire Department approved a fire clearance for which the applicant has applied for. The home is a single story structure consisting of 4 bedrooms, 2 1/2 bathrooms, kitchen, dining room, family room, garage, backyard with a covered patio, and fenced pool with locked gate. The facility is utilizing video surveillance on the exterior areas of the home. The bedrooms were observed to have bed, lighting, night stand, chest of drawers and area for sitting. The only access to room #4 is by going through bedroom #3. The bathrooms had nonskid mats, 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 116 degrees Fahrenheit. The facility is equipped with flashlights, night lights and solar panels. The facility has an emergency disaster plan, dementia plan and infection control training 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 with manual. Continued on LIC809-C.... 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 grounds. The sharps/knives are stored in a locked cabinet in kitchen. The medications will be kept in individual boxes that will be stored in a locked kitchen cabinet. Upon entry to the home in the left wall the required postings (facility sketch, resident council, theft and loss policy, personal rights, PUB475 CCL/dept complaint poster) were observed to be posted. Poster for Long Term Care Ombudsman is to be posted. The facility was observed to have activities to encourage socialization such as, several board games and books as well as a covered patio with outdoor space for walking and physical activities. Backyard opens to hole #6 of Indian Palms Country Club. Pre-Licensing is incomplete and the following corrections to be resolved. Obtain a new Centralized Applications Bureau (CAB) approved facility sketch showing 3 bedrooms for residents. Bedroom #4 can only be accessed through bedroom #3. (Per Section 87307 Personal Accommodations and Services (a)(2)(C)). Obtain Long Term Care Ombudsman poster. Liability insurance (pending license number). Pre-licensing is incomplete until the above deficiencies are resolved. A follow up pre-licensure LIC809 will be generated upon resolution of deficiencies. An exit interview was conducted and a copy of this report was provided to applicant, Lorenzi Nunez.