Pre-licensing visit·June 19, 2024

Licensing Program Analyst (LPA) Jill Clancy-Czuleger, conducted an announced pre-licensing inspection. License application is for (6) total capacity, of which 6 maybe non-ambulatory. Fire clearance was granted on April 04,2024. LPA met with Mylin Villanueva (applicant-administrator) and Claro Villanueva (applicant-licensee). 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. 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 they were purchased on 12/28/2023. The two-in-one carbon monoxide and smoke detector tested and observed functional. ....continued next page LPAs observed the following: First aid kit did not have a thermometer or manual. Hot water temperature in one of the bathrooms tested and measured at 103.8. degrees Fahrenheit. Beds did not have sheets or mattress protectors Equipment and supplies for residents' personal hygiene are available and on site. Upon receipt of proof of corrections for the items above, by June 28, 2024 LPA J. Clancy-Czuleger will inform CAB. Issuance of license is pending upon final review by CAB analyst. Exit interview conducted and copy of this report provided.