Pre-licensing visit·June 9, 2023

On 06/09/2023 at 8:48 am Licensing Program Analyst (LPA) J. Clancy-Czuleger arrived unannounced to conduct a change of ownership pre licensing visit. LPA met with Dennis Sayson, Licensee and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. Fire extinguishers were observed fully charge and tags showed serviced December, 02, 2022. The two-in-one carbon monoxide and smoke detector tested and observed functional. Continued on 809-C page... ...Continued from 809 LPA observed the following during the inspection: Two of the three residents did not have appraisal needs and services plan. two staff records do not have LIC 508, LIC 501, or employee rights storage house in back needs new doors, broken concrete around storage outside incomplete first aid kit Upon receipt of the proof of corrections for the 4 items above, LPA J Clancy-Czuleger will inform CAB. A exit interview was conducted, and a copy of this report has been provided. Accordingly, LPA will submit a copy of this facility evaluation report to CAB for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.