Pre-licensing visit·November 6, 2024

THIS IS AN AMENDED REPORT. Licensing Program Analysts (LPAs) Christine Dolores and Santino Fortes arrived announced to conduct the facility's pre-licensing inspection. LPAs met with Brenda Ritter (Regional Director of Operations) and Carol Pickard (Senior Executive Director). The facility's fire clearance is approved for 205 capacity in which 193 may be non-ambulatory and 12 may be bedridden. All rooms are approved for non-ambulatory / bedridden residents. The facility is connected to a commercial building and Gallery Cafe (located near the first-floor entrance) that is not part of the facility's license. According to the applicant, the café may be opened in year 2025 and the residents may have access to the Gallery café which is not part of the licensee or excluded from the license. Between the community and Gallery café can be accessed through a door (passageway) by a using a key card on the wall to enter both ways from inside the Café and in the facility. The applicant states the Gallery Café may or may not be employees of the facility. The applicant states that if they are employees of the facility, they will ensure compliance with Title 22. The applicant was informed that if they are not part of the facility’s employees that the staff who work in the Gallery Café should not be allowed inside the premises of the facility unless the individual is escorted or supervised by the facility staff. LPAs toured the facility with Brenda and Carol to include the exterior, underground garage, first, second, third, fourth, fifth, and sixth floor. All indoor and outdoor passageways and stairwells were free and clear of obstruction. There are 2 courtyard emergency exits doors that are able to freely open wherein they do not contain any locks that prevent the doors from opening. Stairwell #1 and #2 observed with an evacuation chair located on the fourth and sixth floor. Facility temperature maintained between 69 - 73 degrees F. Elevators observed to be in working condition. There is no swimming pool or other bodies of water observed. Adequate lighting are present in the hallways and common areas. Pull cord devices that includes an emergency call button observed throughout the facility were randomly tested in each floors and are operational. Applicant stated that resident calls are captured through a staff radio (pagers) and a list of calls are registered via PALCare Software. SEE LIC809-C. The first floor contains a concierge desk, office rooms, activity room, screening room, salon, gym, kitchen and dining room. Restrooms on the first floor contains pull cords, hand-washing signs, and an ADA compliant door button. Posters observed to include if you see something say something, ombudsman, resident rights, resident council, and theft and loss policy. Kitchen equipped with plates, bowls, utensils and cups. Refrigerator temperature maintained at 45 degrees F. Freezer temperature maintained at 0 degrees F. Fire extinguisher in the kitchen last serviced on 10/01/2024. The second floor will be used for the memory care unit. The second floor is equipped with 2 functional delayed egress doors approved by the San Jose Fire Department per STD650 Fire Clearance. There are 2 elevator rooms located in different areas of the memory care unit. Each elevator room contains a door in between the elevator room and hallway of the memory care unit. The doors contain a key fob to access the elevator room, which staff will be provided the access to. Resident bedrooms equipped with adequate lighting, a personal thermostat, and personal bathroom. All bathroom shower contains a shower chair, non-slip floors, grabs bars, and locked drawers / cabinets. Bathroom hot water temperature in RM 223 maintained at 109.2 degrees F. The kitchen refrigerator temperature maintained at 36 degrees F and freezer temperature maintained at -5 degrees F. Food warmer observed in the kitchen area. The dining room observed with plates, bowls, utensils, and cups. Medication room, housekeeping storage, and laundry room observed with a locked door. First aid kit observed in the medication room. Medication room is not yet supplied with the medication carts which will contain the sharps container. Windows and window screens observed in good repair. According to the applicant the third, fourth, fifth, and sixth floors is the assisted living units (AL unit). Applicant stated that future residents that will be admitted, in the AL unit, are a combination of residents who are independent who only require minimal assistance with ADLs. Each floor has centrally stored locked medication room and laundry room. Third floor’s hot water temperature measured at 120 degrees F. RM 407 hot water temperature maintained at 122.7 degrees F. During visit, the hot water temperature was adjusted and observed at 110.4 degrees F. RM 522 hot water temperature maintained at 118.2 degrees F. RM 651 hot water temperature maintained at 111.0 degrees F. Facility has an emergency disaster plan and infection control plan. Flashlights observed in some of the fire extinguisher boxes. Facility is equipped with a back-up generator. COMP III is waived as applicant has reviewed COMP III in other Watermark Facilities in California. Pre-Licensing is complete and this facility has no deficiencies. 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 Brenda Ritter, Carol Pickard, and Mike Hughes and a copy of the report was provided.