Pre-licensing visit·August 6, 2024

Licensing Program Analyst (LPA) Debbie Correia conducted an announced Pre-Licensing visit. LPA identified herself to Applicant Maria Williams and was granted entry into the facility. The purpose of today's visit was to inspect the facility to ensure compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 11/30/23 and the facility is approved for 6 non-ambulatory residents, 1 of which may be bedridden in room 4. The facility has an approved Hospice waiver for 2 resident s . During today's visit, LPA toured the facility and inspected all common areas, outside spaces, and resident rooms across the facility. The facility was found to be clean, safe, and in good repair with no pathway obstructions. Private and common resident bathrooms were observed to be clean and the toilets and showers were observed to be in working order, with grab bars and a non-skid shower floor mat. The facility's water temperature of resident bathrooms measured at 109.3 degrees Fahrenheit. LPA observed locked storage areas where all hazardous and/or toxic chemi cals were s tored and secured. LPA also observed locked storage for resident medications and files. Fire extinguisher was observed and foun d to be in compliance. Functioning carbon monoxide detector and smoke detectors were observed in the facility. Facility is equipped with a first aid kit and manual and PPE supplies. No bodies of water were observed near or on the premises. Per Applicant Williams there will be no firearms kept on the premises. Required postings were observed in a common area of the facility. LPA reviewed the applicant's Infection Control Plan and Emergency Disaster Plan. LPA conducted Component III with the applicant. The topics discussed were continuing operation requirements, record keeping/reporting, and physical plant compliance. 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 Maria Williams, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights.