Facility Evaluation Report

On 05/23/2024, Licensing Program Analyst (LPA) Walton arrived for an announced Pre-Licensing Inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Administrator, Mikayla Ramirez and PLAD, Jill Bivins. This is a 4 bedroom and 4 bathroom home. The facility was granted a fire clearance for 4 non-ambulatory clients. The facility has not accepted clients at this time.

Facility tour conducted. Required postings were observed. Facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Common areas were properly furnished and had adequate lighting. Fire extinguishers were observed with a service date of: 11/07/2023. Smoke detectors and carbon monoxide detectors were tested and observed to be operational. Facility has a sprinkler system. Kitchen toured. LPA observed dishes and utensils. Knives will be kept in a safe in the kitchen. Cleaning supplies will be kept under the kitchen sink. Medications will be locked and inaccessible to clients in the medication room. The First Aid Kit was observed to have the required supplies.

Residents' bedrooms were observed to be adequately furnished with bed, dresser, a night stand and adequate lightning. Mattresses and box springs were in good condition. A sufficient supply of linens was observed. Bathrooms were observed to be operational. Hot water was tested. Hot water temperature measured between 115.0 - 116.2 degrees F.

Exterior tour conducted. Facility has an in-ground pool. LPA observed a fence at least five-feet high and the fence did not obstruct the pool view. There is a covered patio area outside the facility. Facility is approved for delayed egress.

Component III was also conducted and completed. Exit interview conducted. LPA found that all Pre-licensing Requirements were met. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.