Pre-licensing visit·August 29, 2024

Licensing Program Analyst (LPA) Martha Arroyo conducted a Subsequent Pre-Licensing Visit to the facility today. The reason for this visit is to update the fire clearance approved after the pre-licensing visit initiated on 08/09/2024. LPA met with Applicant Representative, Sara Jackson as this is a change of ownership application from Sally’s Residential Care Home #565800345 to Sally Residential Care Home 2 #565850409. The applicant has obtained fire clearance for a total capacity of six (6) residents, all of which may be bedridden in bedrooms #1 - #4. The facility has a dementia program in place. During today’s visit, the LPA toured the physical plant areas to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations and conducted a medication review. The following was observed: The LPA observed two (2) resident restrooms, which were clean and sanitary and in operating condition with non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. The LPA observed four (4) resident bedrooms; two (2) bedrooms are designated as single occupancy; and two (2) bedrooms are designated as double occupancy. All resident bedrooms were observed to be furnished appropriately and had sufficient lighting. Fire clearance also approved for staff bedroom on premises. The LPA inspected the kitchen/food service area. The facility has a sufficient supply of perishable and non-perishable food. All indoor and outdoor passageways were free from obstructions in case of an emergency. No bodies of water noted at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809... Physical plant is consistent with the updated facility sketch/floor plan and fire clearance approved from 08/14/2024. The physical plant of this facility location is in compliance with Title 22 regulations at this time. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. The report was reviewed, and a copy was provided.