Pre-licensing visit·April 19, 2024

Licensing Program Analyst (LPA) Amy Domingo conducted an announced Pre-Licensing and Comp III visit. LPA Domingo was joined by Applicant/Adminitrator Julie Norris and granted entry into the facility. The purpose of the visit was 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 02/20/24, and the facility was approved for 5 non  ambulatory residents and 1 bedridden resident. During today's visit, LPA, accompanied by applicant, toured the facility inside and outside and inspected every room. The facility was found to be in good repair with no pathway obstructions.  Clients' bedrooms were observed to be clean and resident accommodations included furnishings, linens and personal hygiene items; resident bathrooms were equipped with grab bars, bath mats; staff and administrative records are located in a locked office; food service including dishes, utensils, food storage and a seven day supply of non perishables and a two day supply of fresh perishables are present; toxic substances are stored locked in the garage or the office; medication storage and administration logs are located  in a locked cabinet in the kitchen; first aid kit and current first aid manual are located in the office; activities, supplies and sufficient space to conduct are present; fire extinguishers are affixed with a current tag; smoke and carbon monoxide detectors are present and operable; facility posting requirements are present in a common area and the facility administrators certification is current; no pools or other body of water is present on the facility; per the applicant there are no guns, weapons or ammunition located on the property. Discussed with the applicant were continuing operation requirements, record keeping and physical plant compliance. The applicant shall contact the Centralized Application Unit (CAU) for completion of this pending facility application. An exit interview was conducted with Julie Norris, and a copy of this report and Licensee Appeal Rights (LIC 9058) were were printed and given to Julie Norris Administrator.