Pre-licensing visit·May 18, 2023

Licensing Program Analyst (LPA) Cassie Yang arrived announced at the facility to conduct a Pre-licensing inspection for the change of ownership. LPA met with Administrator, Rebecca McFadden. LPA wore the following Personal Protective Equipment: surgical mask. During today's visit, LPA observed four (4) residents to be present in their rooms, and one (1) resident was out of the facility during the time of inspection. Currently one (1) resident on hospice services. This application is a change in ownership. Facility has a clearance for six (6) non-ambulatory residents. LPA and Administrator toured the interior and exterior of the facility. Areas toured included but not limited to: common areas, office, resident bedrooms, bathroom, kitchen, staff room, and backyard. LPA observed medications to be centrally locked and stored in the office. LPA observed residents file to be locked and stored in the office. LPA observed cleaning products and other toxins to be locked away. LPA observed knives and sharps found to be locked and secured in the kitchen. Fire extinguisher was last serviced 3/3/2023. LPA observed the facility to have adequate food supplies, 7+ days of non perishables and 2+ days of perishables. LPA observed the facility to have the required postage on the wall. LPA and Administrator complete the prelicensing tool together, and found the facility to be at compliance. Component III was waived during today’s inspection as Applicant David Deluca was recently Administrator certified and a previous licensee. Additionally, Administrator Rebecca McFadden, will remain at the facility. Applicant satisfied all requirements in accordance to Title 22, California Code of Regulations on today's pre-licensing inspection. A copy of this report was provided to the facility. Exit interview conducted.