Affinity Assisted Living.

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Licensee Lauren Malapitan and Administrator Jade Concha and was granted entry to the facility. Licensed capacity is (6) current census (6). LPA was accompanied by Licensee Lauren Malapitan to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated space for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (4) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. No issues were observed. LPA reviewed (4) resident medications. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 No issues were observed. Additionally, LPA also reviewed (4) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. No issues were observed. Based on the observations made during today’s visit, no deficiencies was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Licensee/Administrator Lauren Malapitan and Administrator Jade Concha.

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Licensee Lauren Malapitan and was granted entry to the facility. Licensed capacity is (6) current census (5). LPA was accompanied by Licensee Lauren Malapitan to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated office for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (5) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. No issues were observed. LPA reviewed (5) resident medications. **Continuation on LIC809C* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 No issues were observed. Additionally, LPA also reviewed (5) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. No issues were observed. Based on the observations made during today’s visit, no deficiencies was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Licensee Lauren Malapitan.

Licensing Program Analyst (LPA) Amy Goldenberg conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. An initial application to operate a Residential Care Facility for the Elderly was submitted to the Central Applications Unit (CAU) on 06/20/2023 for a total capacity of 5 non-ambulatory and one bedridden resident. Fire Clearance was granted 07/19/2023. LPA Goldenberg observed the following: Structure: Facility was a single story house with four (4) resident bedrooms, two and one half bathrooms, living room, dining area, and kitchen area. Heating/Cooling System: Central heating and air conditioning systems. Bedrooms: All bedrooms were adequately furnished with bed, chair, large closets, appropriate linens, adequate lighting, and an operational smoke alarm. Bathrooms: Bathrooms have a working toilet, wash basin, and shower with an adequate supply of towels, toilet paper, and toiletries. Water temperature measured by LPA and thermometer read by LPA at 118 F. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Cleaning supplies and knives/sharp instruments were secured in a locked cabinet. There was adequate room for food storage. Refrigerator/freezer were in working condition and had sufficient storage for perishable food. There was adequate seating for meals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Living/Family room: Furnished with safe and adequate seating and furnishings. All items appear to be in good repair. Yards/Outside: The back was completed was a patio with adequate covered area for providing shade. There were no obstructions. There were no bodies of water observed anywhere on the property. Garage: Garage was organized and free of obstructions. Emergency Phone Numbers, and Exit Plan: Let-Us-No poster and clients rights are posted. General items: The facility has smoke and carbon monoxide detectors. These were tested and remain operational. LPA observed a facility phone and it was verified to be operational by LPA. COMPONENT III with the applicant was conducted during this Pre Licensing Inspection. This facility physical plant is prepared for licensure at this time. A copy of this report was reviewed with and provided to the applicant.