Pre-licensing visit·September 16, 2024

Licensing Program Analyst (LPA) Christina Valerio arrived announced to conduct the Pre-Licensing Visit and complete Component III. LPA met with Licensee Youngsuk Cho, and explained the purpose of the visit. The facility has an approved fire clearance to service individuals aged 60 years and older, approved for six (6) non-ambulatory residents. Non-ambulatory residents may reside in bedrooms 2, 3, and 4. The facility has a hospice waiver for two (2) resident. LPA Valerio reviewed the facility's Emergency Disaster Plan and Infection Control Plan. The facility has a dementia care plan on file. LPA, LPM, and Licensee conducted a walk-through of the physical plant inside and out to ensure compliance with Title 22 regulations. LPA observed resident bedrooms to be fully furnished, clean, and organized. Resident bathrooms were observed to be stocked with hygiene supplies, a trash can, skid mats, hand rails, and shower chair. Hot water was measured at 107.4 degrees, which is within the required range of 105-120.0. Common areas were fully furnished. LPA Valerio observed where medications, cleaning supplies, files, and sharps will be locked and inaccessible to residents. Exterior areas were observed to be furnished with areas for outside activities. No emergency exits were obstructed. Fire extinguisher, carbon monoxide detectors, and fire extinguisher were in working condition. The facility is equipped with interconnected smoke alarms in all sleeping rooms and hallways leading to sleeping rooms and all dwelling areas. The home is fully sprinklered. Component III was conducted and completed. Licensee had no further questions. Pre-Licensing is complete and this facility has no deficiencies. An exit interview was held, and a copy of this report was provided.