Pre-licensing visit·March 17, 2026

Licensing Program Analyst, LPA, Noel Wolf Petersen Arrived to the facility announced to conduct a Prelicensing inspection. LPA met with Izah Singerman to explain the purpose of the visit. Physical inspection included the kitchen, its absent of the 2-days perishable, 7 days non perishable food, it has lockable storage for sharps, toxics, and medications. LPA is asking for the licensee to buy some food and send some photos. Fire extinguishers are dated 8/25. Bathrooms have functional hardware, the water is measured as 105-120* F. first aid kit has required items. Common interiors areas are clean, The outside common areas has some high grass. LPA is asking for some pictures of the back yard in a state free of trip hazards. emergency evacuation gate swings freely and latches closed. LPA reviewed Staff roster, LIC 500 has a plan for 13 staff and an administrator. Sample staff file: had sections for, health screenings backround check, first aid/cpr training, and initial and continuing training. LPA reviewed Client roster, lic 9020(blank). Sample Client file: had sections for admission agreement, amendments to the addmision agreement, Health screenings(TB), recent medical assesment, function capabilities assessment, needs and services plan, ongoing care notes, and emergency contact information Administrator documents included, HIV Training, the administrator certificate, Liability insurance and Workers comp, property control(Grant deed), LLC(sole member) secretary of state log, all files are present and up to date. Comp 3 presentation was just given in Vallejo about three weeks back. LPA cut it down to highlight the rules that are specific for the larger facilities(specific staffing, signal system, awake staff, addional staff training requirements, administrator training requirements, etc.) No citations issued, the facility is ready for licensure when the backyard is clean and there is food in the house for the clients. Send to pictures (noel.wolfpetersen@dss.ca.gov) for review and approval by 3/20/26.