Pre-licensing visit·July 25, 2022

Licensing Program Analyst (LPA) Carmen Lopez conducted an announced Pre-Licensing and Component III inspection at a Residential Care Facility for the Elderly 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. After arriving at the facility, LPA identified herself, disclosed the purpose of the visit and was granted entry by Paulo Ordinanza, Licensee. LPA toured the physical plant, inside and out, and observed the following: Resident accommodations were in compliance with regulations, including furnishings, linens, and personal hygiene items; resident bathrooms were equipped with non-skid flooring, and water temperatures measured at: kitchen faucet 108.1 degrees Fahrenheit (F), faucet in staff bathroom #1 107.2 degrees F, bathroom #2 107.8 degrees F; the facility’s ambient room temperature was 68.4 degrees F at the time of the visit; medications will be stored in a locked cabinet drawer in the open office area. Staff records and resident records will kept in a secured locket cabinet in the open office area; Food service was within the requirements of regulations, including dishes, utensils, and food storage. Licensee will have a seven (7) day supply of non-perishables; the two (2) day supply of perishables once residents are admitted. Knives and sharp objects were inaccessible to residents in care; toxic substances were stored in a locked cabinet under the sink; detergent will be stored in the laundry area inside the locked garage; first aid kit, manual and required supplies were stored in a locked cabinet in the open office area. Activity supplies will be purchased. There is sufficient space in which to conduct activities; fire extinguisher was present at the facility; smoke and carbon monoxide detectors were present and operable; required facility postings were present and visible in the common area of the facility. According to the administrator, there are no guns, weapons, or ammunition stored on the facility property. The facility does not have a swimming pool or bodies of water. LPA conducted and completed the Component III with the Licensee Paulo Ordinanza during the visit. LPA verified his understanding of Title 22 continuing requirements, including physical environment, reporting requirements, personnel and resident records, incidental medical care, health related services and activities. No deficiencies were observed during today's visit as 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. The Licensee was advised that the application is pending management final review and approval. An exit interview was conducted and a copy of this report and Applicant Rights (LIC 9058) were provided at the conclusion of the visit. The signature below confirms that documents were received.