Pre-licensing visit·April 29, 2025

On 04/29/2025 at 10:03 AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted a Pre-licensing Inspection. LPA met with Licensee/Administrator, Paul Henry and explained the purpose of the visit. 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. The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB) : 1.)LPA observed facility does not have a professionally installed grab bars in all three (3) showers in residents’ shared restroom. Continue on LIC809C Continued from LIC809 2.) LPA observed facility does not have complete bedding for all six bedrooms, beds are missing mattress pads and blankets. 3.) LPA observed facility does not have an exit sign in the backyard identifying emergency exit. 4.) LPA observed facility does not have a dementia plan and observed the plan does not address behaviors such as ingestion of toxic chemicals and wandering behaviors. 5.) LPA observed facility does not have PUB 475 20x26 and Ombudsman poster. 6.)LPA observed facility does not have emergency disaster plan (9 pages) posted. Comp III will be conducted during follow-up visit. Licensee/Applicant will submit proof of corrections to CCLD on/before 05/06/2025. Exit interview conducted and a copy of this report provided.