Pre-licensing visit·May 7, 2021

Licensing Program Analyst (LPA) Praveen Singh conducted a Pre-licensing Inspection on today's date. Due to the Governor's present shelter in place order, this inspection was completed via video-conference with Applicant/Administrator Mynette Boykin. This facility currently has six residents and is operating under license number 079200531 . This Pre-Licensing is relative to facility's change of ownership application. The facility has six (6) private resident bedrooms and one (1) staff room. LPA toured facility inside and out, including bedrooms, bathrooms, living rooms, kitchen, dining area, and outside areas. LPA observed that bathrooms contained grab bars and non-skid mats. LPA observed a sufficient supply of extra linens and a locked cabinet for centrally stored medications and resident/staff files. LPA observed a sufficient supply of dishes and utensils. LPA observed a sufficient supply of perishable and non-perishable foods. LPA observed Large Ombudsman and Community Care Licensing's If You See Something... posters were posted on the wall. LPA observed auditory signals, fire extinguishers, first aid kits, smoke alarms, and carbon monoxide detectors. Fire extinguishers were last serviced in February 2021. There were safety night lights in the hallway and in the resident bedrooms. Exits and passageways were free of obstruction. LPA observed that facility is not yet ready to be licensed. During today's inspection, a discrepancy was discovered regarding the facility's Fire Clearance. Once resolved, LPA will conduct a final Pre-Licensing inspection of the facility. See LIC809 (Case Management Report) dated 5/7/2021, for Comp III Review conducted today. Exit interview conducted and a copy of the report provided via email.