Pre-licensing visit·February 22, 2024

On 02/22/24, Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a Pre- Licensing visit. LPA met with Administrator, Chris Faamausili and explained the purpose of the visit. This application is a change in ownership (CHOW). The address is currently licensed as Elizabeth Care Homes 3, Facility #342700725 . Administrator holds a current administrator certificate (# 6039698740 with expiration date 06/08/24 ). The facility currently has 5 residents during today's inspection. Facility has a fire clearance for 6 non- ambulatory residents. LPA and Administrator conducted a tour of the interior and exterior of the facility. Areas toured include but are not limited to: residents bedrooms, bathrooms, kitchen, dining room and common areas. Bedrooms have appropriate furnishings. Grab bars were present in the bathroom.The facility has a food supply of, 2 days of perishable and 7 days of non-perishable food items. Smoke detectors and carbon monoxide detectors are present and operational. The Fire extinguisher was last serviced 09/15/23. All exits were unobstructed. All toxins, medications,and sharps were locked and inaccessible to residents in care. Facility's temperature was 74 degrees during todays inspection. Hot water temperature was observed to be 110 degrees Fahrenheit, which is within the regulation range of 105-120 degree. First aid kit present and maintained. LPA reviewed one (1) resident and one (1) staff file and found that all required paperwork was present . Component III was waived as the current administrator has been administrator for other RCFEs licensed by CCLD. LPA will forward findings to the Centralized Application Bureau (CAB) that facility met all the pre-licensing components. Applicant has 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.