Pre-licensing visit·June 22, 2021

Licensing Program Analysts (LPAs), Kristina Ryan, and Debbie Correia conducted an announced Pre-Licensing visit to observe the facility's compliance with Title 22, Division 6 regulations and the California health and safety code. LPAs met with Administrator, Charles Bloom and Regional Director of Operations, Maria Rossi. Facility is applying to serve one hundred and one (101) residents over 60 years of age. All rooms at the facility are approved for non-ambulatory use. During today's visit LPAs, accompanied by Administrator Bloom and Regional Director of Operations, Maria Rossi, conducted a facility tour. LPA's observed resident rooms and found them to have proper furnishings, and adequate linens. Sinks accessible to residents had water temperatures measured between and 109.6 to 118.8 degrees Fahrenheit. Facility temperature was read at 72 degrees Fahrenheit. Facility had multiple working fire extinguishers. Smoke and carbon monoxide alarms were observed and operational. The Encinitas Fire Department granted clearance on May 24, 2021. Facility had preparation space for food service and kitchen was observed to have all needed supplies for food service. Space inside the facility is sufficient for activities. Administrator stated that there will be no weapons or ammunition kept on the facility property. Facility has an indoor pool with a locked entrance that meets the requirements of Title 22. Staff and resident records will be stored in a locked cabinet. There is a shaded outdoor space and appropriate resident activities. All cleaning supplies or potentially hazardous materials were locked. Facility has a locked area for resident medications and first aid kits. Administrator Certificate expires on February 6, 2022 . Component III was reviewed with the Administrator Charles Bloom Regional Director of Operations Maria Rossi. The application will be sent to the Centralized Application Bureau for final review and approval. An exit interview was conducted with Administrator, Charles Bloom and Regional Director of Operations, Maria Rossi. A copy of this report and Licensee Appeal Rights (LIC 9058 01/16) was provided vie email. An electronic read receipt confirms receipt of these documents.