Pre-licensing visit·July 11, 2024

Licensing Program Analyst (LPA's) K.Kaur and J. Leffall conducted a Pre-licensing Inspection on this date. LPA's met with Licensee/Administrator Melanie Rafanan and Jose Pira. A tour of the facility was conducted together. This is a new facility with no residents in care. The facility was observed to be at a comfortable temperature, and in good repair. LPA’s did not observe operational telephone service. No passageway obstructions or fire hazards were observed inside or outside. Common areas were properly furnished and well-lit throughout. LPA’s observed Dining table located in kitchen. Table is not sufficient for 6 residents. Knives and sharps are locked in cabinet in kitchen. Fire extinguisher observed in the kitchen with a service date of 3/26/2024. Medications will be locked in cabinet located in kitchen area. Scissors not observed in First Aid Kit. Living room is equipped with adequate futon and chairs for residents. Cleaning and Chemical supplies observed locked in laundry room next to the washing machine. Resident’s bedrooms were observed to be adequately furnished with bed, dresser, chair and adequate lighting. LPAs did not observe nightstands in resident rooms. Mattresses and linen were in good condition. Extra linen and towels are available in the hallway cabinets. Carbon monoxide and smoke alarm detectors installed and operational. Grab bars installed in shower and by toilet, non-skid mats in place, hand soap and paper towels available for use. Trash cans with tight fitting lids are in place. Complaint poster posted, resident council info posted, residents' rights posted, emergency disaster plan posted. LPA’s did not observe nondiscrimination and theft policy. Adequate outside space for rest and recreational under a patio with sufficient seating. LPA’s observed excess broken items. LPA’s observed unlocked garden tools and ax in backyard. Gate is self-closing and self-latching. The following issues will need to be corrected prior to pre-licensing visit and Licensure of facility: 1. Liability Insurance 2. Facility Telephone Service Continued to LIC 809C 3. Post nondiscrimination and theft policy 4. Licensee to lock garden tools, ax, sharps. 5. Remove broken items in backyard not in use. 6. Missing scissors from First Aid Kit 7. Night-stand in each resident room Pre-licensing requirements were not met. An exit interview was conducted with Licensee/Administrator. Report signed on-site by Licensee and printed copy provided