Pre-licensing visit·January 4, 2023

On 1/4/2023 at 10am Licensing Program Analysts (LPA) Simi Rai arrived announced to conduct the facility's pre-licensing visit. LPA met with Licensee Elizabeth Bautista & Armando Guba. There are no clients present on site. During visit, LPA toured the facility to include the living room, family room, kitchen, garage ,2 bathrooms, 5 bedrooms, dining room and exterior. All fire exit routes were free and clear of obstruction. Toxins observed secured. Facility has an approved fire clearance for 5 non-ambulatory clients and 1 bedridden client. Facility has a central entry point for symptom screening and temperature check for all clients, staff, and visitors. Bathrooms supplied with hand washing sign, hygiene products, and paper supplies. LPA observed the carbon monoxide detectors to be in working condition. Hot water temperature maintained between 108.9 - 110.3 degrees Fahrenheit. Facility temperature maintained at 70 degrees Fahrenheit. First aid kit supplied with tweezers, bandages, gauze, scissors, and thermometer. Battery operated flashlights observed on-site. Medications will be stored in a locked cabinet. Kitchen observed to have areas to lock sharp supplies. LPA observed the facility to have Personal Protective Equipment (PPE) supplies. The following posters observed to include the emergency telephone numbers, personal rights, RCFE compliant poster, complaint information, Rights of Resident Councils, Personal Rights of Residents in All Facilities, required mask, and facility sketch. No issues noted during this pre-licensing inspection. LPA observed the facility is ready to be licensed. However, this report will be submitted to the Central Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. This report was reviewed with Licensee Elizabeth Bautista & Armando Guba and a copy of the report was provided.