Pre-licensing visit·November 5, 2021

On 11/05/21, Licensing Program Analysts (LPAs) M. Yang and K. Kaur arrived announced to conduct a Pre-Licensing inspection. The facility is a 4 bedroom and 2 bathrooms home and fire clearance was granted for 2 ambulatory an d 2 non-ambulatory for a total of 4. There are no residents present during this inspection. LPA toured inside and outside of facility. No obstructions observed. Knives will be kept locked and secure in the kitchen cabinet. Dishware and utensils observed. Centrally stored medication observed in locked two kitchen cabinet. Chemicals observed in stored and locked in garage. First aid kit observed completed. LPAs observed an extra supply of bed linens and personal hygiene products. One bedroom has sufficient furniture and lighting. Bathroom observed to have grab bars for use of toilets. Bathrooms have non-skid mat. LPAs observed the water heater not operating. LPAs unable to check water temperature. Facility set at comfortable temperature. Fire extinguisher was last serviced 09/28/21. Smoke and carbon monoxide combination detector tested and operational during inspection. The following will need to be brought into compliance: 1. Grabbed bars in bathroom for use of shower 2. Furnished livingroom 3. Wood board removed from facility exit doors 5. Binds/ covering in livingroom and master bedroom windows 6. Hallway lightening 7. Operating water heater Licensee will need to contact LPA once items are completed. LPA will need to return for a follow-up inspection. Comp III was conducted during today’s pre-licensing visit. Exit interview conducted. Administrator was informed that as COVID-19 precautionary measure, this report was provided via email. Report signed on-site.