Pre-licensing visit·May 6, 2022

Licensing Program Analyst (LPA) Tung Truong arrived announced to conduct a Pre-licensing visit on 5/6/2022 at 10:30 AM. LPA met with Kassia Mitchell, Applicant and stated the purpose of today’s visit. The facility will be licensed for a capacity of 6 non-ambulatory residents. Applicant, Kassia Mitchell holds a current Admin certificate # 6020161740 which will expire on 09/05/2022. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed rooms to have required furniture. LPA observed there were no residents in care at this time. LPA observed 2-day perishables and 7-day non-perishables. The temperature inside the facility was observed to be at 74*F which is within the required range of 68-85*F. The hot water temperature was measured at 119.3*F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. Report continued on 809-C Based on a review of this facility during this Prelicensing visit, it was determined that this facility was found to be in compliance at this time. LPA discovered that the facility designated Administrator Kassia Mitchell and Patrick Cain has completed Component III before and will therefore waive this requirement. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview held, copy of report given.