Pre-licensing visit·August 10, 2023

Licensing Program Analyst (LPA) Angela Hood met with the Administrator, Mirasol Mungcal, to conduct a Pre- Licensing visit for a change of ownership. There are currently 5 residents with 1 additional resident moving in 8/11/23. Administrator has a current certificate #6048112740 with an expiration date of 4/24/2024. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are six (6) bedrooms and three (3) bathrooms for resident use. 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 112.3 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two-day perishable and (7) seven-day non-perishable food supply on hand. LPA observed knives, cleaning products and other toxins to be locked away and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA observed the outdoor area and perimeter of the care home to be free of clutter and debris and there appeared to be no potential safety hazards to the residents in care. LPA checked medication storage and found medication to be locked away and inaccessible to the residents. LPA reviewed (2) resident files and two (2) staff files. Pre-licensing passed and LPA waived Component III. 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.