Pre-licensing visit·December 2, 2025

Licensing Program Analyst (LPA) Hannah Rodgers conducted an announced Pre-Licensing visit. LPA was met by Applicant Marjorie Hechanova and was granted entry into the facility. The purpose of today's visit is to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on October 3, 2025, and the facility is approved for six (6) non-ambulatory residents of whom one (1) may be bedridden. Hospice waiver approved for six (6). During today's visit, LPA toured the facility and inspected every room. The facility was found to be clean, safe, and in good repair with no pathway obstructions. Resident bathrooms were observed to be clean, and the toilets and showers were found to be in working order. The facility's water temperature was measured in compliance. LPA observed locked storage areas where all hazardous and/or toxic chemicals were stored and secured. LPA observed locked storage for residents’ medications. Fire extinguisher was observed in the facility and found to be in compliance. A functioning carbon monoxide detector and smoke detectors were observed in the facility. No bodies of water were observed near or on the premises. LPA observed 7-day supply of non-perishable food and a 2-day supply of perishable food. Required postings were observed in a common area of the facility. LPA reviewed facility’s Infection Control Plan and Emergency Disaster Plan. LPA conducted Component III with the applicant. The topics discussed were continuing operation requirements, record keeping/reporting, personnel requirements, health related services/conditions, and physical plant compliance. [CONTINUED ON LIC809-C] Pre-licensing is complete, and this facility has no deficiencies. It is recommended that this facility be licensed pending final review and approval. An exit interview was conducted with Applicant Marjorie Hechanova, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.