Pre-licensing visit·January 27, 2022

Licensing Program Analysts (LPA's) Treana White and Maja Jensen arrived announced to conducted a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA's met with Administrator Youngsuk Cho who assisted LPA's in today’s inspection. Fire clearance licensed for 6 non-ambulatory residents. The facility administrator’s certificate #: 6056802740 which expires on 07/23/2023. LPAs inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. LPAs observed all hallways and passageways to be free of clutter or hazards. LPAs observed kitchen was clean and in good repair. Facility has (7) seven day supply of non-perishables. Resident bedrooms were checked and were observed to be adequately furnished. LPAs observed adequate supply of linens. LPAs tested water temperature in client's shared bathroom measured at 117.9 degrees F. LPAs observed locked areas where items such as but not limited to, knives, medication, and toxins will be stored inaccessible to residents. LPAs toured the back yard and side of house to ensure safety. Smoke detector and carbon monoxide in operating condition during inspection. LPAs observed fully charged fire extinguisher. First aid kit observed to be complete. LPAs observed mitigation plan completed. Emergency Disaster Plan last dated on 12/20/2021. LPAs discussed the Component III with Administrator. Based on observation and interview it appears the facility is ready to be licensed. The report will be forwarded to the centralized application unit for continued processing. No deficiencies cited during inspection. Exit Interview conducted with Administrator and a copy of report given.