The facility is a one story home with five resident and one caregiver bedrooms, three bathrooms, a living room, a kitchen, a dining area, and an attached two car garage. LPAs measured the temperatures in three of three bathrooms and were between 117.5 to 117.8 degrees Fahrenheit. All exiting doors had alarm notifications. There are backyard exit gates on the sides of the house that are self-latching and unlocked with auditory alarms. There is a shaded seating area and LPAs did not observe any obstacles or hazards in the backyard. The fire extinguisher was serviced and charged on October 15, 2024. LPAs observed the See Something, Say Something poster (PUB 475), Personal Rights, Weekly Activities Calendar, Menu and Emergency Disaster Plan in the facility mounted on the wall in the hallway.

Resident bedrooms had the required furnishings. LPAs observed all beds had linens and blankets. All toxic chemicals, cleaning solutions, and disinfectants are inaccessible to residents and will be stored and locked underneath the kitchen sink. Medications will be stored in a locked cabinet. The first aid kit has all the required elements. Reading materials and games were observed in the living room with a phone and tablet for resident use. A supply of seven-day non-perishable food was observed and will be maintained on hand. AD will provide two-day perishables upon receipt of residents in care. Smoke detectors and carbon monoxide detectors tested operational. Gas burner stove, dishwasher, refrigerator, microwave, washer, and dryer are operational.

LPAs conducted the Component Three Orientation with AD. AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted and a copy of this report was provided to Licensee.