Pre-licensing visit·February 6, 2023

On 02/06/2023, Licensing Program Analyst (LPA) arrived unannounced to conducted a Pre-Licensing (CHOW) Inspection of the facility to ensure compliance with Title 22 regulations. LPA Avelina Martinez met with Marnelli Johnson and explained the purpose of today's visit. Facility has a fire clearance for six non-ambulatory residents. There are currently four residents residing at this facility. During today's visit, there were two care staff working. In addition, Marnelli Johnson, will be the Administrator of this facility. LPA Martinez inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. The facility is sanitary and furnished. The facility temperature measured at 73 degrees and water temperature measured at 115 degrees. The facility sketch and resident room numbers were updated. Additionally, an STD 850 was completed. The facility has an adequate food supply, and the kitchen is sanitary. Restrooms and resident rooms were sanitary and furnished. The facility has resident and staff files. The facility has a first aid kit. The facility has one main Covid-19 screening entry point and sign in sheet. The facility has the required postings. The applicant has passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. The Applicant is the Licensee of another licensed care facility. The Applicant has previously completed component III, as a result LPA Martinez waived the Component III for this facility. An exit interview was conducted, and a copy of this report was provided to the Applicant.