Pre-licensing visit·February 16, 2024

Applicant SZB LLC has applied for RCFE licensure for 6 non-ambulatory elderly clients over age 59 in 6 rooms. Fire clearance has been approved. Facility is currently licensed and operating under the name Millbrae Paradise Retirement Home #410508755, which is reflected on application (LIC200). There are 5 residents present; no one is receiving hospice care. LPA Jeung toured facility and grounds of this one level facility. There are 6 private bedrooms--one with private half bathroom--staff room, 2 full bathrooms, living room, dining room, and kitchen. There are 2 beds in staff room. Clothes washer and dryer are located in 2-car garage. The backyard is level, fenced and mostly paved, and there are 2 detached storage sheds. Medications and toxins are secured in locked cabinets in kitchen and garage, respectively. Hot water temperature is tested at 105 degrees in front bathroom. Food preparation and service items are present, as well as perishable and non-perishable fruits vegetables and protein. Supplies of bed and bath linens and hygiene products are observed. Sophia Chen is a certified administrator (x8/25). The following items are observed and must be addressed prior to licensure: 1. An internet access device dedicated for resident use--such as a computer, smart phone, tablet, or other device that can support real-time interactive applications, equipped with videoconferencing technology, including microphone and camera functions--must be maintained. (HSC 1569.319) 2. A set of keys--including all resident units, facility vehicles, all exit doors, all cabinets, cupboards or files that contain elements of the emergency and disaster plan, including, but not limited to, food supplies and protective shelter supplies--must be available to staff on each shift for use during an evacuation. (1569.695) 3. Emergency Disaster Plan (LIC610E) must be updated to include corrected utility shut off and fire extinguisher locations. (Section 87212 Emergency Disaster Plan) LPA to be contacted upon completion of the above 3 items. Facility phone number is verified: 650/697-2201. Applicant shall not retain bedridden persons, as there is no fire clearance approval for bedridden residents. Client #5 is bedridden, per MD report. Component III RCFE orientation is reviewed with licensee/administrator Sophia Chen. RCFE licensure is pending at this time.