Pre-licensing visit·May 29, 2025

At approximately 1:30PM Licensing Program Analyst (LPA) Contreras arrived unannounced for a pre-licensing change of ownership visit and met with Residence Care Coordinator and responsibility designee, Mary Grace Defeo. This pre-licensing inspection is for a Residential Facility for the Elderly being conducted for a one story, four bedroom, 2 bath home with a fire clearance approved for capacity of 6 ambulatory and non-ambulatory residents. Currently 6 residents reside at facility. LPA toured the facility with admin and of the indoor and outdoor portions of the facility. Facility was found to be clean and at a comfortable temperature. Facility contained all required postings. Emergency exits clear and free from obstruction. Outdoor area has patio and chairs accessible for resident use. 4 out of 4 bedrooms found in clean and good repair. Two shared rooms. All had required chair, chest drawer and beds were made with appropriate linens. Restrooms had grab bars but no bath mats, admin agreed to provide bath mats for all restrooms. LPA observed emergency food and water supply with 7 day non-perishable foods available. LPA observed no expiration dates on food items. LPA discussed with admin the importance of food expiration dates on all food items under current facility Tree Duck Residential (#486804121). Cleaning products, sharp items, other toxins and chemicals are locked and inaccessible to clients. Extra linens and towels are kept in storage closet. LPA observed fire extinguisher charged and last inspected 5/4/2025. Fire alarm and carbon monoxide alarms were tested and operational. First aid kit available. Water was measured at 106.7 degrees F in faucets used by clients which is within regulation between 105 & 120 degrees F. Signal system on all doors leading out of facility were tested and found operational. continued on 809C... Continued from 809.. LPA reviewed 2 resident records and 2 Staff records, which were all found to be well organized, thorough and contained required documentation. LPA conducted medication spot check and observed all medication to be centrally stored and secure. Medication was found to be pre-poured in locked cabinet and was cited under previous license T ree Duck Residential( #486804121 ) . LPA discussed importance with new admin of not pre-pouring medication. Thick-It Thickener was found to not be centrally stored. Admin removed Thick It Thickener and locked with medication. Component III orientation was conducted at facility with admin. No Deficiencies o r Advisories given during visit. Deficiencies given under previous license Tree Duck Residential (#48680412) Pre-Licensing completed. Facility is ready to be Licensed as a Residential Facility for the Elderly. LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicants of Status. Copy of report discussed and provided to Applicants. Exit interview conducted.