Pre-licensing visit·February 24, 2025

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct a Pre-Licensing Inspection regarding a change of ownership application & met with Applicant/Administrator, Nino Flores & Administrator, Jean Rice. The home has an approved fire clearance by the Vallejo Fire department on 10/15, 2024 for six (6) non-ambulatory residents, of which one may be bedridden. Home has an approved Hospice waiver for 2 of the residents. This home is a one story residence with three resident bedrooms, 2 bathroom, living room, dining room, kitchen area and the garage. There is an approved staff bedroom in the home and the fire department approved an additional staff bedroom in the outside. LPA will request update and changes to the facility outside sketch to reflect staff bedroom approval that was noted on a follow up visit/fire inspection on 10/28/2024. Resident rooms have the required furnishings in resident bedrooms. Bathroom showers have non-skid shower floors/mats and grab bars. Water temperature in bathrooms is within regulation of 105 & 120 degrees F. Home has sufficient items used for cooking and eating. Cleaning supplies and sharps are locked in kitchen cabinets. Personnel records, resident records and medications are stored in locked cabinet. Auditory alarms on doors were operational. Carbon monoxide and smoke alarms are operational. Fire extinguisher is charged and service 6/17/2024. LPA reviewed staff & resident files and found complete and organized. Required postings were observed. Administrator certificate for Jean Rice #7006023740 exp 10/1/2026. Applicant explained they have the liability insurance ready to be issued by INSUREMYRCFE. Applicant to submit copy of Liability Insurance to Centralized Applications Bureau Analyst or LPA Canela. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulation. Component III was conducted today, with Applicant, Nino Flores and Administrator, Jean Rice. Pre-Licensing is complete. No citations issued.