Pre-licensing visit·July 3, 2024

Licensing Program Analyst (LPA) Cassie Yang arrived announced at the facility to conduct a pre-licensing inspection utilizing the inspection tool. LPA met with applicant, Rahel Abebe, and explained the purpose of the visit. During today's inspection, LPA observed chemicals were left in the laundry area with no locked access. LPA and Applicant addressed that all chemicals are to be stored and locked. Applicant stated chemicals will be moved to the garage in a lock cabinet. LPA and Applicant continued tour in the kitchen and observed knives to be in the cabinet with no locks. LPA informed Applicant all sharps are to be locked and inaccessible to residents in care. LPA inspected five bedrooms total, four will be used as residents room and one will be staff room. LPA observed two bedrooms to be complete furnished. LPA observed the common areas to have couches. LPA informed Applicant that facility should have activities available for resident to accessible. LPA provided Applicant a copy of PUB 475 and informed Applicant it needs to be 20"x26" and posted in the common areas. LPA and Applicant discussed facility LIC 200 to be for six ambulatory. Applicant stated she has completed the required criteria from Sac Metro Fire for non-ambulatory clearance. Applicant stated she will submit a new LIC 200 for non-ambulatory status. During today's visit, LPA provided Applicant a copy of 22 CCR 87211, HSC 1569.605, HSC 1659.625, LIC 200, LIC 311F, LIC 603, LIC 603A, LIC 625, LIC 601, LIC 602, LIC 604A, LIC 613C, LIC 621, LIC 622, LIC 624, LIC 9020 and LIC 9060. Comp III has not been completed as today's inspection is not approved for licensure. Applicant will make corrections. Additionally, Applicant will resubmit LIC 200 and facility sketch to the Department. Exit interview and a copy provided.