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25 | Licensing Program Analyst (LPA) Ruth Wallace conducted a Pre-Licensing Inspection via Microsoft Teams Tele-visit on March 1, 2021. LPA Wallace met with Licensee Angelita Dayoan and Administrator Nicholas Padua . Administrator Certificate expires 9/10/2022 . LPA explained purpose of the visit. Currently there are 0 residents residing within the facility. A fire clearance was granted on 12/16/2020. Smoke detectors were inspected and carbon monoxide detectors are operational. Fire extinguishers indicators revealed a full charge and were inspected on 5/21/2020.
Facility was inspected both indoors and outdoors. Outdoors was clean, tidy with adequate shading. Outdoor exits are clear and accessible. No hazardous debris noted.
There is a Locked Medication Room for resident medication/personal records. The emergency exiting plan, Resident rights, and licensing complaint poster is posted. All posters for COVID and Instructions for Hand Sanitation are posted. Facility has a First Aid kit and Personal Protection Equipment For COVID. Facility has appropriate linens for residents. There is adequate lighting throughout. Two private bedrooms and two shared bedroom that have appropriate furnishings, chair, adequate lighting and storage. There are two bathrooms that are clean, sanitary, and in good repair. Hot water temperature was measured at 112.0 F degrees. Kitchen is clean sanitary, and in good repair. The kitchen has operable appliances. There is a locked area for cleaning supplies and toxins. All sharps are located in a locked drawer, and sufficient utensils are available. The 7 day non-perishable food requirement is met. All staff had the required 1st aid/CPR, Criminal Record Clearance and were associated to the facility.
Pre-Licensing inspection passed and no deficiencies cited. Component III was not completed because Licensee has been licensed since 2015. Exit Interview conducted and a copy of this report was sent via Email with "read receipt." Administrator will sign 809 and send back via email to LPA Wallace. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulations. A copy of this report will be forwarded to the application unit. |