Pre-licensing visit·October 21, 2021

Licensing Program Analyst (LPA) A. Canela conducted thisLoving Hearts Care Home II pre-licensing inspection on 10/21/2021, for this change of ownership application. LPA met with applicant Rose Devera, and Luisa Datuin, who will be the Administrator for LOVING HEARTS CARE HOME II . The facility received a fire clearance approval from the Vallejo Fire Department on 7/13/2021 for a total of 6 Non-ambulatory residents. Applicant will ensure sufficient staffing at all times. The facility is one level home with 5 bedrooms , of which 4 bedrooms may be used for residents and 1 bedroom used for staff. There are 2 full bathrooms, living room, dining room, kitchen, laundry room and garage. The garage has a room that is used as an office and two sofas that facility states is used for staff to take a break and facility understands the garage is not approved for sleeping. The staffs bedroom has two beds and will be used for sleeping. During today’s visit LPA observed the following items: · COVID-19 postings and screening station at entrance · Lockable separate cabinets for medications, toxin, and knives. · All exits were unobstructed · 6 smoke and 2 carbon monoxide detectors, which were all operational. · First Aid kit and flashlights for emergency lighting. · Supply of linens, paper products, and hygiene supplies available. · Non-slip mat and grab bars in bathrooms. · Fire Extinguisher charged and serviced 07/1/2021 · Required facility postings were observed · The water temperature was tested during inspection and within regulation of 105-120 Degrees F. · LPA observed at least a minimum of a 2 day supply of perishable and 7 day supply of non-perishable food necessary for 5 residents. Component III Orientation was completed with Applicant Rose Devera. Pre-Licensing is complete, LPA will notify Application Unit Analyst in Sacramento; Application Unit Analyst will notify applicant of application status.