Pre-licensing visit·January 26, 2022

Licensing Program Analyst (LPA) Michael Hood met with applicant, Steven Ronstadt, to conduct a Pre- Licensing visit. This application is a change in ownership. This address is currently licensed as OLD RANCH VILLA Facility #: 342700035. The facility has a fire clearance for 6 non-ambulatory residents. Applicant holds a current administrator certificate (#6051256740 with expiration date 2/26/2023). LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are six bedrooms and four bathrooms for resident use, along with one bedroom and one bathroom for staff. LPA observed facility to be properly furnished, including appropriate bedding and lighting in bedrooms. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 116 degrees F. LPA checked the kitchen area for the ability to prepare and store food. LPA observed at least a 2-day perishable and 7-day nonperishable food supply at the facility. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home are operational. Fire extinguisher is ready for emergency use. LPA reviewed two resident files and two staff files. LPA observed during visit that first aid kit was missing a manual and resident files were missing Needs and Services Plan. LPA indicated all the above observations need to be fixed and facility will send corrections to CCLD within 7 days from today's date. Pre-licensing passed and Component III waived. Applicant has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.