Pre-licensing visit·August 20, 2024

At approximately 8:45AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Change of Location Pre-Licensing Visit and met with Licensee/Administrator, Christine Woltering. Facility serves older adults and has a plan of operation for dementia care and programming on file. Facility received an approved fire clearance on 08/09/2024, which states that facility has a total capacity for 6 non-ambulatory residents of which 2 residents can be bedridden. Facility has an approved hospice waiver for 1 individual. Upon arrival, LPA was informed that there were 2 Residents in care. At approximately 8:50AM, LPA conducted a walk-though of the facility with Licensee. LPA observed the following: Facility is a one story building with 4 bedrooms, 2 1/2 bathrooms, and common spaces. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Hot water temperatures for all sinks were found to be within Title 22 Regulations of 105 to 120 degrees Fahrenheit. Facility's fire extinguishers were last inspected April 2024. Smoke and carbon monoxide detectors were tested and operational. LPA confirmed that contents of the facility's First Aid Kit were sufficient. Per Licensee, there are no changes to facility's plan of operation or program with the change of location. No Deficiencies or Advisories given during visit. Pre-Licensing completed. LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicant of Status. Exit interview conducted. Copy of report discussed and provided to Licensee/Administrator. Signature on form confirms receipt of documents.