Pre-licensing visit·February 10, 2022

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an announced Pre-Licensing visit. LPA was met by Applicant Dan Raphael and was granted entry into the facility. The purpose of today's visit is to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 1/6/2022 and the facility is approved for 6 non-ambulatory residents. There were 5 residents in care during the visit. During today's visit, LPA toured the facility and inspected every room. The facility was found to be clean and in good repair with no pathway obstructions. Client bathrooms were observed to be clean and the toilets and showers were found to be in working order. The facility's water temperature in bathroom 1 was measured at 110.5 degrees Fahrenheit and bathroom 2 was measured at 112.3 degrees Fahrenheit. LPA observed locked storage areas where all hazardous and/or toxic chemicals were stored and secured. LPA observed locked storage for clients' medications. Fire extinguishers were observed throughout the facility and found to be in compliance. A functioning carbon monoxide detector and smoke detectors were observed in the facility. No bodies of water were observed near or on the premises. LPA observed 7-day supply of non-perishable food and a 2-day supply of perishable food. Required postings were observed in a common area of the facility. LPA conducted Component III with the applicant. The topics discussed were continuing operation requirements, record keeping/reporting, and physical plant compliance. LPA reviewed and approved the applicant's COVID mitigation plan. Pre-licensing is complete, and this facility has no deficiencies. It is recommended that this facility be licensed pending final review and approval. An exit interview was conducted with the applicant and a copy of this report was provided via email.