Granny's Place #9

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Michael Tea conducted an announced visit to the facility for the purpose of completing a pre-licensing inspection. LPA met with the designated Administrator (AD), Michelle Nesbitt. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by the Department on March 5, 2025, for a total licensed capacity of six (6) residents, all of whom may be non-ambulatory. Fire clearance was approved by the Orange County Fire Authority on November 6, 2025. The facility is a single-story home consisting of six (6) resident bedrooms, a staff room, four (4) full bathrooms, one (1) powder room, laundry room, living room, kitchen, dining area, and an attached garage. The home has two exit gates located on each side of the house, both of which are self-latching and secured. A shaded seating area is available in the backyard for resident use. LPA did not observe any safety hazards or obstructions. Recreational materials, including games and puzzles, were observed for resident use. LPA observed the Administrator Certificate, facility sketch, and Emergency Disaster Plan posted at the front entryway. The “See Something, Say Something” poster (PUB 475), Long-Term Care Ombudsman poster, and Personal Rights were also prominently displayed. Resident bedrooms were observed to be appropriately furnished. Motion sensor devices were installed in each room to monitor resident movement and assist with fall prevention and overall safety. Bedrooms with direct access to the backyard/outdoors were equipped with functioning door alarms. All beds were observed with adequate linens and blankets, and an ample supply of linens and towels was available. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Hot water temperature in (Pre-Licensing Report continuation on LIC 809-C) the bathrooms measured approximately 113.0°F. Bathrooms were clean, operational, and equipped with a working toilet, wash basin, and bathtub/shower. Grab bars and non-skid mats were in place to ensure resident safety. Toxic substances were observed to be secured and locked underneath the kitchen sink, laundry room, and garage. Medications will be stored in a locked hallway closet near the kitchen. A fully stocked first aid kit was observed mounted near the medication storage area, along with a first aid manual. Resident and facility records will be securely stored in the same locked closet, with the majority maintained electronically. A working telephone was observed in the kitchen. Video surveillance cameras (without audio) are installed in common areas for safety monitoring. The facility also has a laptop available for resident use to maintain communication with family and plans to acquire an iPad for additional resident access. An adequate supply of non-perishable food was observed. All appliances, including the stove, refrigerator, dishwasher, microwave, washer, and dryer, were operational. Sharp objects are stored in a secured kitchen drawer. Emergency food, water, and additional supplies were observed to be adequately stocked in the garage. A fire extinguisher located near the medication closet was observed to be fully charged. Based on today’s inspection, the facility appears ready for licensure. LPA conducted Component III Orientation with Administrator Michelle Nesbitt. The Administrator was informed that 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 the Administrator.the state’s words, verbatim · CDSS document, Mar 19, 2026

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Initial Capacity: 6 Census (if any clients in care): none COMP II Participants: ANGELICA KUTNERIAN, Applicant JOZEF SPRINGER, Administrator Interview Method: Virtual interview (Microsoft Teams) On November 3, 2025, 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, Nov 3, 2025