Pre-licensing visit·August 11, 2022

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an announced Pre-Licensing visit. LPA was met by Applicants Lauren Delancey and Almina Street 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 5/6/2022 and the facility is approved for 4 ambulatory residents and 2 non-ambulatory residents in bedroom #3. The facility has an approved hospice waiver for 4 residents. 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 the private bathroom was measured at 112.6 degrees Fahrenheit and the shared bathroom was measured at 110.7 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. 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 a 7-day supply of non-perishable food. Required postings were observed in a common area of the facility. LPA observed no grab bars in the bathrooms, no non-skid mats in the showers, and no linens or toiletries for resident use. LPA did not conduct Component III with the applicants. Pre-licensing is not complete and the applicant must install grab bars and non-skid mats in bathrooms and purchase linens and toiletries for resident use. The applicant will contact the LPA when the changes have been made to reschedule the pre-licensing inspection. An exit interview was conducted with the applicants and a copy of this report was provided via hard copy.