Pre-licensing visit·February 20, 2025

Licensing Program Analyst (LPA) Victoria Brown arrived announced on 2/20/25 at 10:30am and met with Applicant Beatrice Clark and stated the purpose of the visit. This visit is to conduct a Pre-Licensing Inspection. LPA was allowed entry into the facility that will be licensed and fire cleared for a capacity of 6 non-ambulatory residents. Administrator certificate expires on 10/30/25. LPA observed that the facility has submitted an Infection Control Plan. Facility is fire cleared for rooms 1-4 for Non-ambulatory residents. LPA and Beatrice Clark toured and inspected the physical plant inside and outside to ensure there are no health and safety concerns. LPA observed the kitchen area, dining area, bedrooms, bathroom, storage areas, back yard and laundry area in garage. LPA observed knives/sharps area to be locked. LPA observed required furniture, and lighting throughout the facility. The hot water temperature measured at 115.7 *F which is within the required range of 105-120*F. The temperature inside the facility measured at 76*F which is within the required range of 68-85*F. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The first aid kit included supplies such as sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA observed area for centrally stored medications to be locked. LPA observed the fire extinguisher(s), smoke and carbon monoxide detector(s) and exit alarms on doors in the home. Facility has central heating and air. LPA observed the area where the staff and resident files will be locked and readily available for review. Component III conducted - There are no objections to licensure at this time. -Licensure pending. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations cited during this visit. An exit interview was conducted and a copy of this report was provided.