Pre-licensing visit·July 18, 2024

At approximately 1:45 PM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a pre-licensing inspection and was greeted by Licensee Applicant, Leslieann Enriquez. This pre-licensing inspection is being conducted for an initial licensing of a Residential Care Facility for the Elderly (RCFE). Fire Clearance has been approved for five (5) non-ambulatory residents. Facility has a waiver for three (3) residents receiving Hospice services. Facility has submitted a dementia plan to CCL as well. Licensee Applicant is currently in partnership with North Bay Regional Center (NBRC) and plans for resident placement upon issuance of license. At approximately 2:00 PM, LPA initiated a tour of the facility and observed the following: Facility is a one story home with auditory signals activated on all exits, was a comfortable temperature, and passageways were free from obstructions. Water temperature in residents' bathrooms measured at approximately 135 degrees F, which is above the allowable range of 105 to 120 degrees F per Title 22 regulations. Licensee Applicant lowered the water heater temperature two separate times during inspection and the water temperature did not change. LPA observed resident showers with the required non-slip mats, but 1 of 4 bathrooms was missing the required grab bars. Licensee Applicant agreed to install some. LPA observed a supply of incontinent care products and paper products available to residents. LPA informed Licensee Applicant of the need to increase the facility's supply of towels, bedding sheets, and hygiene products. Hallways are equipped with night lights and residents' bedrooms have all the appropriate furnishings as outlined in Title 22 regulations. There is a sufficient amount of dishes and cooking supplies for resident use with sharps and other hazardous items kept secured in various designated drawers and cabinets as well as under the kitchen sink. Cabinets in communal areas of the facility containing cleaning supplies and other items that could pose a risk were observed locked. Facility has at least two days of perishable foods, but does not have at least one week of non-perishable foods or emergency water. LPA observed a sample menu posted in the common area to indicate a healthy and balanced set of meals for residents in care. Continued on LIC809-C... continued from LIC809... The facility has internet service but does not currently have telephone service or an internet access device for resident use. Licensee Applicant agreed to obtain a designated phone and phone service for the facility as well as an internet access device for resident use. Facility has a designated area with locked cabinets for centrally stored medications and resident, staff, and facility files. LPA observed the facility's infection control plan, first aid kit, PPE, other emergency supplies, and games available for resident use. LPA informed Licensee Applicant that the facility shall increase it's PPE supply and post an activity schedule for residents viewing. Facility has one fire extinguisher, which was purchased in January 2024 and is fully charged. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Licensee Applicant has posted hard copies of the required emergency disaster plan and maps, admissions agreement, theft and loss program, personal rights information, and reporting posters in facility communal areas. LPA informed Licensee Applicant that visiting hours shall be posted as well. Licensee Applicant will begin hiring additional staff once license approved and NBRC approves the facility's vendor application. Licensee is aware of the association and staff transfer process. Licensee Applicant provided LPA with a copy of the facility's lease agreement, affidavit regarding client resources, and surety bond. Licensee Applicant to submit proof of liability insurance. The backyard features paved walkways and a patio with shaded seating for resident outdoor use. Windows and blinds are all found to be in good repair and facility exits are clearly identified. LPA observed bedroom #4 missing a window screen and bedroom #3 requiring a new one. LPA informed Licensee Applicant of the need to remedy this before the follow-up pre-licensing visit, which will be scheduled at a later date. Component III orientation was conducted with the Licensee Applicant at facility. Licensee/Applicant conveyed knowledge and understanding of Title 22 regulations. Today's pre-licensing evaluation has been completed, and a follow up visit is needed to verify all identified deficiencies are remedied. Applicant to submit proof of correction (POC) for each technical assistance issued today via form LIC9102 before LPA will schedule follow up inspection. Exit interview conducted with Licensee, whose signature on this document confirms receipt .