Pre-licensing visit·April 20, 2023

At 10AM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an unannounced pre-licensing visit and met with applicant. LPA explained the purpose of the visit with applicant. Facility has an approved fire clearance dated 03/08/23 for 6 residents. There are 3 bedrooms and 2 bathrooms. Emergency Disaster Plan and posters such as complaint poster and Personal Rights were observed displayed in common areas. All bedrooms were observed furnished with a bed, dresser, closet, night stand, lamp and chair. Hallways and passageways were free of obstruction. There was sufficient lighting and furniture. The kitchen was observed clean and organized. There was sufficient supply of non-perishable foods observed. Hot water measured at 109 deg F. There was a locked cabinet for medicine and resident files. Knives and other sharp objects and chemicals were kept in a locked drawer and cabinets in the kitchen & garage. There was sufficient supply of towels, sheets, blankets and hygiene products observed. Smoke detector and carbon monoxide were tested and observed operational. First aid kit was complete. There were activity materials available. Facility has a washer and dryer installed in the garage. LPA observed chairs and table in the backyard with a covered porch for use of residents. There were no bodies of water observed. No deficiencies observed during visit. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Branch (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. Exit interview conducted and a copy of this report provided to applicant.