Facility Evaluation Report, 01/15/2025 — Kinah Mae Home RPV, Rancho Palos Verdes CA

On 01/15/2025 The Department of Social Services, Community Care Licensing Division (CCLD) staff conducted an announced visit to the facility for purpose of a pre-licensing evaluation. Today’s pre-licensing evaluation was held, in-person, with staff one Renette De La Cruz, Administrator (S1).

On 07/31/2024 an application was submitted to CCLD, for an initial license for a Residential Care Facility for the Elderly to serve Elderly adults from ages 60 and above. Requested capacity is for six (6) clients of which five (5) may be non-ambulatory and one (1) client who is bedridden. The facility has a hospice waiver for six (6) clients in care. The facility is a single-story home which includes four (4) bedrooms, two “half-bath” (2) bathrooms, one (1) kitchen, (1) dining room, one (1) living room, with an attached garage, and is located within a residential neighborhood.

CCLD staff conducted a review of the Physical Plant, Bedrooms, Bathrooms, Supplies, Food Service, Medications, Records, Administration, Activities, Pre-Licensing Checklist and Component III Orientation with S1.

There is a locked centralized storage area for client medications.

Facility is clean, sanitary, and in good repair. Protective devices are in place to include fire prevention and mitigation and all are operational. Indoor and outdoor passageways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions. There is one (1) pool, located in the back yard with a locked 5ft-high fence surrounding the water, making the water inaccessible to residents in care. There are locked storage areas for poisons, pool chemicals and sharps. All window screens are clean and in good repair. Facility maintains a comfortable temperature at 77.5 degrees F. The facility has central air. Inclines, ramps, open porches, and areas of potential hazard are well-lit and adequately equipped for elderly residents. Nine (9) smoke detectors are hard wired and operate properly. Two (2) Carbon monoxide detectors operate properly. S1 shut off the facility power source to indicate emergency lighting as operational.