Pre-licensing visit·January 28, 2025

On 01/28/2025 at 10:15AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted a Pre-licensing Inspection. LPA met with Licensee, Filmon Yemane Gebrekidan/Administrator, Filmon Berhe Woldemariam LPA toured facility including but not limited to resident's bedrooms, bathrooms, living room, dining area, kitchen, garage, and outdoor area. LPA observed lighting in all rooms. LPA observed facility had some non-perishable food supply. Licensee will purchase additional food supplies once facility is licensed. Carbon monoxide and smoke detectors was observed in operating condition. First aid kit was complete. Emergency disaster plan was complete. Fire Extinguisher last serviced on 03/08/2024. LPA will conduct the Comp III presentation on next visit. The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB): 1. LPA observed Hot water was measured at 140.1 degrees F in the shared bathroom sink. 2. LPA observed the common bathrooms does not have paper towel holders. 3. LPA observed common bathrooms does not have night lights available. 4. LPA observed bedroom #1 is missing a bed, chair and chest of drawers. Continue on LIC809C Continued from LIC809 5. LPA observed all six (6) beds in residents rooms does not have blankets, bedspreads, top bed sheets and mattress pads. 6. LPA observed facility does not have signal system. 7. LPA observed facility does not have Resident Rights/Information - 20"x 26" PUB 475 poster 8. LPA observed Outdoor activity areas that are easily accessible to residents, does not have adequate shady area for residents. Licensee/Administrator has ordered table with umbrella. 9. LPA observed back gate has a mechanical lock and facility does not have a fire clearance with locked perimeter. LPA requested licensee to either obtain property fire clearance or remove the mechanical lock on back gate. Licensee/Administrator agreed to remove the lock. Licensee/Applicant will make the corrections before 2/6/2025. Exit interview conducted and a copy of this report provided .