Pre-licensing visit·December 13, 2022

Licensing Program Analysts (LPAs) Avelina Martinez and Pang Lee arrived unannounced to conducted a Pre-Licensing CHOW Inspection of the facility to ensure compliance with Title 22 regulations. LPA Avelina Martinez and LPA Pang Lee met with Susan Nagtalon, and explained the purpose of today's visit. Facility has a fire clearance for 6 non-ambulatory residents. Administrator,Mariam G. Soumahoro will be the Administrator of this facility. LPAs inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. The facility has the required postings, and has Covid-19 postings throughout the facility. The facility has one main Covid-19 screening entry, and log in sheet. The facility has established resident and staff files. In addition, the facility has a first aid it. The facility smoke detectors, carbon detectors, and fire extinguishers are in good repair. The facility has an adequate food supply, and has kitchen utensils. Also the water temperature measured at 120 degrees, and the facility temperature was 75 degrees. The facility has a public telephone, and has an area for activities. Resident bedrooms were furnished, and resident bathrooms were in good repair. Mariam has other licensed facilities, and has completed component 3 prior to this pre-licensing. Component 3 has been waived for this pre-licensing. The applicant has passed the pre-licensing component of the application process. LPA Martinez will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. An exit interview was conducted, and a copy of this report has been provided to the facility.