Pre-licensing visit·December 21, 2023

On 12/21/23, Licensing Program Analyst (LPA) Talwinder Bains met with applicant ,Mary Maybel Mata (Mary) , to conduct an Pre- Licensing visit. This application is a change in ownership (CHOW) . This address is currently licensed as Graceful Senior Care , Facility # 345002799 . The facility currently has no residents during today's inspection. Facility has been fire clearance (date- 09/25/23) approved for 5 non ambulatory residents for room 1-4 and 1 bedridden resident for room 5 only. LPA toured the facility with Mary. LPA toured residents bedrooms and they were properly furnished and maintained. LPA toured common bathrooms and observed to be clean and sanitary. The food supply is within compliance, 2 days of perishable and 7 days’ worth of non-perishable food items. Smoke detectors are operational. There are carbon monoxide detectors which are functioning. The Fire extinguisher was charged, serviced, functional and ready for emergency use . Grab bars were present at the toilet and in the shower. All exits were unobstructed. All toxins, medications, and sharps were locked and stored away. The disaster drill is current. Facility's temperature was 68 degree F during inspection. Hot water temperature was observed to be 110 degrees F, which is within the regulation range of 105-120 degree. First aid kit found to be complete. This facility has two story building and Mary stated that only first floor will be used for residents and 2nd floor will only be used for staff/owner use only. Component III for RCFE was completed with Mary with no issues. 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.