Pre-licensing visit·August 14, 2024

Licensing Program Analyst (LPA), Daniel Pena, conducted an announced Pre-licensing and Component III inspection. LPA was greeted in the lobby by staff and after introducing and identifying himself was allowed into the facility. LPA was greeted by Administrator Megan Franz to whom LPA stated the purpose of the visit. The facility is in current operation with census of fifty-three (53) residents on the day of the inspection. The application for this license requests a change of ownership. LPA verified that the LIC 309 Administrative Organization form was modified to reflect the change. Certificate of Liability Insurance was reviewed and is valid through 05/01/2025 and includes the required coverage limits. A fire clearance was granted on 5/6/2024. The facility is approved to serve seventy-two (72) non-ambulatory and four (4) bedridden residents who may occupy any apartment on the first and second floor. Administrator Franz’ certification is valid through March 2025. LPA, accompanied by Administrator Franz, conducted a tour of the facility which included communal dining, activity and group meeting rooms as well as a sample of resident rooms. Passageways are free from obstructions. There is no pool or other body of water on the property. According to Administrator Franz, no firearms or dangerous weapons are stored on the premises. Residents' bathrooms are clean, sanitary, and in operating condition with grab bars and non-skid materials. Hot water temperatures were recorded at a sampling of faucets for resident's use and measured within 105-120, degrees Fahrenheit. LPA observed carbon monoxide and smoke detector devices which were present and operable. According to facility records, a fire drill was conducted on 7/8/2024. Medications and administration records were observed and stored in a secured location. A sample of resident and staff records were reviewed. Facility staff records contain health screenings, background checks, and First Aid certifications. Resident records include admission agreements, medical assessments, and physician reports as well as a needs and services plans. CONTINUED FROM LIC812 At this time, the facility is operating within compliance with California Code of Regulations, Title 22. Administrator Franz was advised that the application is pending final review and management approval. Component III was also completed. A copy of this report was discussed and provided to Administrator Franz, along with the Licensee/Appeal Rights.