Pre-licensing visit·January 19, 2022

On 01/19/2022, Licensing Program Analyst (LPA) M. Yang conducted an announced Pre-licensing inspection. LPA introduced self, stated the purpose of the visit, and was granted entry into the facility. LPA met with Elysia (Shelly) Boyd, Licensee. The facility is 4 bedroom and 2-bathroom home. Fire clearance was granted for 2 Non-Ambulatory and 2 Ambulatory for total of 6 capacity. There are 4 residents present during this inspection. LPA toured the facility with Licensee. The facility was adequately furnished, well-lit, and at a comfortable temperature. Kitchen was toured and observed to have dishes, plate, and utensils. LPA observed a 2 day supply of perishable foods and a 7 day supply of non-perishable foods. Knives were observed to be locked and secure in the kitchen drawer. Medications were kept locked and inaccessible to residents in care. First aid kit was observed and contained all required items. Cleaning supplies and chemicals were observed to be in a locked cabinet in the garage and under kitchen sink. Bedrooms were observed to have required furnishings. Hot water measured at 110 degrees F in all bathrooms. LPA observed an extra supply of bed linens and personal hygiene products. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching. A fire extinguisher was observed and has a service date of 07/01/2021. Smoke detectors and carbon monoxide detectors were observed to be operational during this inspection. Last fire drill conducted on 01/16/2022. Resident records were reviewed. LPA observed all residents’ Admission Agreements, Physician Reports, and update emergency contact information. All Staff records were reviewed for good health and infection control training. All staff have a criminal record clearance. No deficiencies were cited during the inspection. I have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.