Pre-licensing visit·May 16, 2022

On 05/16/22, Licensing Program Analyst (LPA) L. Salazar arrived at the facility for an announced Pre-Licensing inspection. LPA was greeted by licensee and allowed entry. Upon entry, LPA observed the required facility postings to include disaster plan, personal rights, discrimination notice, theft and loss policy, facility sketch identifying the emergency exits and complaint poster. LPA observed an entry table for screening of COVID precautionary measures. LPA toured the facility inside and out. The facility is a 4 bedroom, 2 bathroom house with a fire clearance for 6 non-ambulatory of which (1) may be bedridden. Any room may be approved for bedridden and a Hospice waiver was granted for (1) . Bedrooms were furnished according to regulation. Bathrooms were observed to have grab bars and non-skid mats in the showers. Water temperature was tested and read 116 degrees F. Hand washing signs were observed in the bathroom. Facility was free from ground obstructions and odor free. Common areas were observed to have adequate seating and lighting available. LPA observed and tested smoke and carbon monoxide detectors in the home. Both were functional. A supply of extra linen and towels were observed in the closet located in the hall near the bedrooms. Kitchen was toured and observed to have dishes, plates, and utensils. Knives will be kept locked and secure in the kitchen pantry. Medications will be locked in a hall closet. First aid kit was observed and contained all required items. Cleaning supplies and chemicals observed to be locked in a cabinet located in the garage. Fire extinguisher was observed with a purchase date of 04/2022. Bedrooms were observed to have the required furnishing and are ready for shared occupancy. Master bedroom will be designated for live-in staff. LPA observed an extra supply of bed linens. Exits were open and free of obstructions. LPA observed side gate to be self-latching. Smoke detectors and carbon monoxide were observed to be operational during this inspection. Component III was conducted during today's pre-licensing visit. Pre-licensing requirements have been met. Exit interview conducted.