Pre-licensing visit·August 11, 2025

Licensing Program Analyst, (LPA) Armando Perez made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA met with Applica nt , Mingchin Nozawa , who accompanied LPA for the inspection. Applicant has submitted an application for six (6) non ambulatory residents in which one (1) is approved for bedridden. On June 18, 2025, Riverside City Fire Department approved a fire clearance for the facility. The facility is a one story home with 3 client bedrooms, 1 staff bedroom, 2 bathrooms, laundry room, living room, dining area, kitchen, and attached garage. LPA observed clients’ bedrooms with the required bedding and furniture, such as, clean mattresses/linen, night stands, dressers, chairs, lighting, and emergency lighting. Client bathrooms and showers had clean appliances that were operating in safe and sanitary condition. Facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. The facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Sharps, such as knives and scissors, will be stored in a locked cabinet in the kitchen. Client and staff files will be in a locked cabinet in the kitchen. Client medication will be centrally stored and locked in the kitchen cabinet as well. The facility has no pool or any bodies of water. There is a covered patio area with sufficient seating for all the clients. All passageways were free from obstruction. LPA observed 2 charged fire extinguishers in the facility with the next service date of December 31, 2026. Licensee is aware the fire extinguisher must be serviced yearly and has until the end of 2026. The smoke detectors and carbon monoxide alarms are a combined unit and were operational. LPA observed a covered fireplace in the living room area that has the required covering. Continued on LIC 809-C. The facility does not have any known firearms and ammunition on the property. LPA observed the required postings of the emergency disaster plan, resident personal rights, complaint procedures, employee rights, visitation rights, facility sketch, and the Long-Term Care Ombudsman poster. Facility contains emergency supplies and first aid kits with the required items. The facility has working telephone for client use. LPA observed Applicant's Administrator Certification on file with expiration date of 12/05/2025. 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 issues or concerns. 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 Mingchin Nozawa.