Facility Evaluation Report

Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced on 05/16/2023 to conduct a pre-licensing inspection. LPA was greeted by lead staff Rowena Radana who called Applicant Jenero Jefferson to attend pre-licensing. Applicant, Jenero Jefferson arrived 2 hours later to complete pre-licensing. This is a change of ownership with clients in care. Fire clearance has been approved for 2 ambulatory and 4 non-ambulatory clients by the County Fire Department. Facility currently has 5 clients.

LPA toured building and grounds which were clean and in good repair. Exits and walkways were free from obstructions. Bathrooms had necessary grab bars and non-slip mats. Facility observed carbon monoxide and smoke detectors throughout the facility. Facility had a sufficient supply of perishable and nonperishable food. Toxins were locked and secured. Medications were locked and secured. First Aid is centrally stored in upper kitchen cabinet.

Facility shares yard area with neighboring sister facility, the two facilities form a closed compound which allows for movement between facilities. Next door facility has changed to new ownership by the same applicant Rameils Sacred Care Home 1 - 286804120 .

COMP III is waived as licensee operates two other licensed facilities in Sonoma County. LPA will notify application unit to proceed with licensing pending submission of LIC 500 . LIC 500 to indicate when administrator is present and which staff are assigned to the facility.

Exit interview conducted with Applicant Jenero Jefferson and a copy of this report given to applicant.

No deficiencies observed during today's inspection.