Pre-licensing visit·April 24, 2025

On 4-24-2025 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 Alyssa Hoang, Administrator, who accompanied LPA for the inspection. The Applicant has submitted an application for (6) residents (6 non-ambulatory and no bedridden). On 3-24-2025, 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) bathrooms, kitchen, formal dining room,, garage, backyard with a covered patio, and fenced pool with locked gate. The facility is utilizing video surveillance on the common areas of the home. 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 110 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 with manual. Continued on LIC809-C...... The passageways, and ramps/inclines are clear and free from obstruction. The home has 2 fully charged fire extinguishers. The facility does not have any known guns or ammunition stored on grounds. 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 in the kitchen. Upon entry to the home on the wall, the required postings (facility sketch, resident council, theft and loss policy, personal rights, PUB475 CCL/dept complaint poster and Long term Care Ombudsman) were observed to be posted. The facility was observed to have activities to encourage socialization as well as a covered patio with plenty of outdoor space for walking and physical activities. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA has determined that the facility met the operational requirements for licensure. The Pre-licensing inspection is complete. The facility has satisfied all requirements in accordance with Title 22 California Code of Regulations. An exit interview was conducted and a copy of this report was provided to Alyssa Hoang.