Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an announced subsequent pre-licensing inspection and met with Applicant/Licensee Margie Isidro. The facility will be licensed as a Residential Care Facility for the Elderly, age range 60 and over to serve six (6) ambulatory residents, of which two (2) may be non-ambulatory in bedroom #1. Accessory Dwelling Unit (ADU) in the back is for staff use only. There are currently 0 residents in care.

During today's visit, LPA performed a final walk through and toured the facility with the Applicant.

LPA observed the following items that have been corrected:

Hot water temperature needs to be adjusted and must meet the Title 22 Regulations requirements of hot water reading to be between 105-120 deg F. : At 10:39am, LPA measured hot water temperature and water temperature readings ranged between 106.5-109.9 deg F.

Install grab bars and nonskid mats in the shower room in Bathroom #1. : Grab bars and nonskid mats in bathroom #1 have been installed.

Need a safe container to dispose syringes and needles in accordance with the Title 22 Regulations 87303 (g)(1) : Applicant purchased a small sharps container.

The laundry machines are in the attached garage and has a very tight space. Submit a plan to make the laundry area accessible and safe for residents. : Applicant cleared the space around the laundry machines and are now easily accessible to use for future residents.

Get mattress pads for the beds in bedrooms 3 & 4. : Applicant has purchased the mattress pads/covers for all (4) mattresses in bedrooms 3 & 4.

Install carbon monoxide. : Carbon monoxide has been installed in the kitchen/dining area. Applicant stated she will purchase a few more to be installed in the hallway and living room.

Install auditory devices in exit points and the doorbell in the front door. : Applicant installed the auditory devices in exit points.

Stock up on additional PPE supplies. : Applicant purchased addition al PPE supplies.

Clear the side yard of the unused bulk items . : Side yard has been cleared.

Clear the front yard of parked vehicles to provide clear access. : Front yard has been cleared.

Lock the cleaning solutions stored in the cabinet under the sink in the 1/2 bathroom. : Cleaning solutions in the cabinet under the sink in the 1/2 bathroom has been locked and made inaccessible to future residents.

Designate an area/place to store the medications for residents. It must be locked, secured and inaccessible to residents. : Applicant designated one of the kitchen cabinets to be the medication cabinet which is locked and inaccessible to future residents.

Applicant must purchase liability insurance. : No current liability insurance, according to CAB Analyst Ricmar Soriano, liability insurance is not a requirement for licensure. Applicant stated she will purchase the liability insurance once she receives her RCFE license.

The following needs to be posted in a visible location in the home:

III. Contact information/list of emergency agencies/Emergency exiting plans

- All policies/information have been posted near the entrance area.

The Pre-licensing deficiencies have been resolved. Pre-licensing is now complete.

An exit interview was conducted, and a copy of this report has been provided to Margie Isidro, Applicant/Licensee . Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the Applicant/Licensee has questions regarding the status of the application, they have been instructed to communicate with their assigned CAB Analyst.