Pre-licensing visit·May 5, 2021

Licensing Program Analyst (LPA) Joanne Roadilla conducted a pre-licensing tele-inspection visit today via Zoom. The Department has suspended on site visits due to COVID-19 shelter in place order by Governor Newsom. The home is currently licensed as Mary's House – 435294190, with 6 residents in care. The pre-licensing is for a change of ownership. LPA met with Administrator (ADM) Elaine Yalung. At around 3:40pm, LPA toured the facility virtually lead by ADM. LPA observed COVID-19 related posters at the entrance to promote social distancing and infection control. A screening station is located by the entry door for checking temperature of any visitors, residents or personnel coming in through the facility. There were complaint, ombudsman, and resident's bill of rights posters observed in the hallway. The thermostat registered the room temperature at 73 deg F. The facility is equipped with connected combination smoke and carbon monoxide detectors, the one located in the living room was tested and observed working. Fire extinguishers were observed by the hallway and in the living room and were last serviced on August 13, 2020. The kitchen, dining and living room were observed in good repair. The water temperature in the kitchen was measured at 117 degrees F. LPA observed at least a 2-day supply of perishable and 7-day supply of non-perishable foods. Continued on LIC809-C. A complete first aid kit was inspected. Centrally stored medications, cleaning supplies and other toxic substances were observed in locked cabinets. PPEs were observed by the laundry area next to the kitchen. Resident bedrooms were observed in good repair, fully furnished, with clean linens and adequate lighting. Bathrooms were observed clean and equipped with grab bars and non-skid mats. The backyard was inspected. All outdoor and indoor passageways were observed clear and free of obstruction. No bodies of water observed. At around 4:30pm, review of Component III was completed with ADM. There were no issues noted during the pre-licensing tele-inspection. The physical plant is approved pending the completion of Centralized Application Bureau (CAB) review of the facility application. Exit interview conducted with and copy of report sent to Elaine Yalung for review and signature.