Facility Evaluation Report

Licensing Program Analyst (LPA) Jason Lund arrived announced to conduct a Pre-Licensing Inspection. LPA Lund met with Sajida Khan and explained the reason for the visit.

LPA Lund and Sajida Khan toured/inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed there are no residents at this time. LPA observed the kitchen area, dining area, bedrooms, restrooms, storage areas, and laundry rooms. LPA observed required furniture, and lighting throughout the facility. The hot water temperature was measured at 115 *F which is within the required range of 105-120*F. The first aid kit included supplies such as sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA observed centrally stored medications area locked and inaccessible to future residents. LPA observed the fire extinguisher(s), smoke and carbon monoxide detector(s) in the home. Facility has central heating and air. Staff and Resident files will be readily available for review and kept in the office locked in a cabinet.

Component III conducted. Licensure pending. The facility is still waiting for approval from Valley Mountain Regional Center (VMRC)

Per the California Code of Regulations, Title 22, Division 6, Chapter 6, no violations were observed during this visit. Exit interview held, copy of report given .