Facility Evaluation Report

LPA Jeung followed up on initial pre-licensing inspection of 7/1/22, as no information has been received from administrator. Since 7/1/22, name change has been made official, and facility is operating as Pacifica Senior Living Burlingame; facility is being managed by Pacifica Senior Living and change of ownership is being processed. On 7/1/22, the following items were observed that needed to be addressed prior to licensure:

1. Emergency Disaster Plan (LIC610E) to be updated with location of fire extinguishers

2. Cage #4 in garage will be identified by signage

- Cage #4 in garage is identified as such with a sign

3. Waste containers in kitchen are observed without tight fitting lids (per Section 87303 Maintenance and Operation)

- Waste containers in kitchen are observed today without covers

4. Laundry machine on 3rd floor is out of order

- Due to painting of walls in first floor common areas, there are currently no postings

- Visitor policy is given to LPA today, and will be posted when common area walls are dry

6. There must always be an administrator designee on-site.

- In-service training on chain of command was provided to staff on 7/14/22

- Copy of sign-in sheet is provided to LPA

Mr. Nair to notify LPA Jeung to confirm that items #1 and #3 are addressed. A follow up visit and Component Three orientation to be conducted.