Cogir of North Bay

Type of visit: Prelicensing

At approximately 9:20AM, Licensing Program Analyst (LPA) Magdaleno arrived announced to conduct a pre-licensing inspection and met with Executive Director Davina Barker. This pre-licensing inspection is being conducted for a Change of Ownership for an existing facility identified as Cogir of North Bay #486803810. Facility is a Residential Care Facility for the Elderly (RCFE). Fire Clearance dated 10/07/2025 is approved for eighty-three (83) residents of which fifty-five (55) can be non-ambulatory in rooms 151-158, 251-273, and 351-388. A hospice waiver has been granted for seven (7) residents. At approximately 10:00AM LPA conducted a walk-through of facility with Executive Director and observed the following: Facility is a four (4) story building with Assisted Living on floors 1-3 and Independent Living on floor 4. Facility was found to be clean and at a comfortable temperature with all exits free from obstructions. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. A spot check of resident sinks measured between 113.7- and 117.6 degrees F which is within Title 22 Regulations of 105 degree F to 120 degrees F. There was an appropriate supply of cleaning products, linens, hygiene products, and paper products available for residents. Toxins were observed to be locked and inaccessible to residents. Bathrooms were equipped with necessary grab bars, and non-slip floors mats were present. Facility has sufficient items for cooking and serving. Medication is centrally stored and locked. Facility has indoor/outdoor areas for visiting and activities. Facility's fire extinguishers were observed to be charged and last inspected 10/25. Smoke and Carbon Monoxide detectors are hardwired and last inspected 10/25. Continued LIC9099C... Continued from LIC9099... Facility has internet accessible devices and internet available for residents in care. LPA and Executive Director discussed many topics including reporting requirements, documentation requirements, grievance procedures, staffing, disaster drills, and yearly training requirements. Facility staff will be transferred from previous facility upon licensure. No Deficiencies or Advisories given during visit. Pre-Licensing completed. Facility is ready to be Licensed as a Residential Care Facility for the Elderly (RCFE). LPA will submit Pre-Licensing Application Report to the Application Unit Analyst. Application Unit Analyst will notify Applicant of Status. Exit interview conducted. Copy of report discussed and provided to Executive Director. Signature on form confirms receipt of documents. Component III presentation was waived by Executive Director.the state’s words, verbatim · CDSS document, Apr 9, 2026

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 83 Census (if any clients in care): 44 COMP II Participants: Name, Title Interview Method:Virtual interview (Microsoft Teams) On March 17, 2026, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant and Administrator’s understanding of following areas: 1. Facility Operation: License Type, Client/Resident Populations, and Program. 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readinessthe state’s words, verbatim · CDSS document, Mar 17, 2026