Pre-licensing visit·June 3, 2021

Licensing Program Analyst (LPA) Adam Hamer conducted an announced Pre-Licensing and Component III visit on today's date to inspect the facility for compliance with Title 22, Division 6, Chapter 8 of the California Code of Regulations and the Health & Safety Code. This is a change of ownership application and the facility currently has two (2) residents in care. LPA spoke with Applicants Bernadette Austria and Virna Austria at the entrance of the facility, identified himself, disclosed the purpose of the visit and was granted entry. LPA and Applicants toured the physical plant, inside and out, and LPA observed the following: Resident accommodations were in compliance, including furnishings, linens, and personal hygiene items; resident bathrooms were equipped with grab bars, non-skid mats, and water temperature measured at 111.4 degrees Fahrenheit in a bathroom used by residents; the facility’s ambient room temperature was 75 degrees Fahrenheit at the time of the visit; there was a cabinet with locked doors for medications, and staff and resident records were kept in a locked filing cabinet; food service, including dishes, utensils, food storage, and a seven day supply of non-perishables and a two day supply of perishables were present, and knives and sharp objects were locked in a drawer in the kitchen; toxic substances were stored in a locked cabinet; first aid kits containing first aid manuals and proper supplies were stored in a facility cabinet; activities, supplies and sufficient space in which to conduct activities were present; two fire extinguishers were present inside the facility, serviced in February 2021; smoke and carbon monoxide detectors were present and operable; required facility postings were present and visible in a common area of the facility. According to Applicants, there are no guns, weapons, or ammunition stored on the facility property. No swimming pool or other bodies of water were observed on the facility property during the visit. The administrators Application for Administrator Certificate for renewal was received by the Department on March 22, 2021 and is in the que to be processed. LPA also conducted and completed the Component III with Applicants during the visit. LPA verified the Applicants' understanding of Title 22 continuing requirements, including physical environment, reporting requirements, personnel and resident records, incidental medical care, health related services and activities. All items reviewed during the visit are in compliance with Title 22, Division 6, Chapter 8 of the California Code of Regulations and the Health and Safety Code. Applicants were advised that the application is pending management final review and approval. An exit interview was conducted with Applicants and a copy of this report and Applicant Rights (LIC 9058 01/16) were provided to them via the electronic mail address provided to LPA; an email read receipt confirms receipt of these documents.