Pre-licensing visit·February 17, 2022

At 12:45 p.m., Licensing Program Analyst (LPA), Emily Peraldi, conducted a pre-licensing visit to this property with applicant representative Eleanor Quintero and Dvora Leventer. This is a change of ownership application from The Colony Valley Glen #1 (#195850098) to Cottages at the Colony of Valley Glen #1 (#195850190). The current census is 4 residents. On 09/09/2021, the applicant obtained fire clearance for a total capacity of six (6) bedridden residents. Between 1:04 p.m.- 1:21 p.m. LPA, along with applicants toured the facility. At 1:17 p.m., LPA toured the kitchen area. The facility has a sufficient supply of perishable and non-perishable food. Kitchen knives are stored in a locked kitchen drawer. Appliances and all equipment appear to be clean and in good repair. The kitchen has a sufficient supply of plates, cups, cook ware and utensils. The freezer and refrigerator are at proper temperature range. At 1:18 p.m. hot water measured at 106.8 degrees Fahrenheit. At 1:04 p.m., LPA observed the fire extinguisher to be fully charged and last serviced on 01/10/2022. At 1:12 p.m., fire alarms and carbon monoxide detectors were tested and were functioning properly. There is a total of six (6) single occupancy bedrooms for resident. Each bedroom is equipped with clean mattresses, pillows, bedding, a dresser and closet space. There is sufficient supply of linens, including blankets, bath towels and wash cloths. Bedrooms have sufficient lighting. There is a total of three (3) bathrooms. Bathrooms have sufficient paper products and soap. At 1:17 p.m. bathroom hot water measured to 105.1 degree- Fahrenheit. There are nightlights present in the hallways. The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. Facility has a working telephone for resident use. Facility has activity supplies such as puzzles. There are flashlights present throughout the facility. Continued on LIC 809-C. Continued from LIC 809 Medications and first aid kits are in a locked medication cabinet located near the kitchen. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away in a locked hallway cabinet. The facility has a central entry point for universal screening. Alcohol-based hand sanitizer is available upon entry. Signs are posted throughout the facility to promote handwashing, and cough/sneeze etiquette. Facility has an adequate 30-day supply of Personal Protection Equipment (PPE). The facility has required postings, including emergency exit plan, Licensing Complaint Poster, Client Personal Rights, and Facility Theft and Loss Program. The garage is locked and attached to the house and laundry units are located inside the garage. There is adequate supply of emergency water, along with emergency nonperishable food. There are no firearms/ammunition stored on the property. At 1:15 p.m. the LPA observed the backyard, which has a covered outdoor area for resident use. There is a latch on the side gate for the emergency exit. Physical plant is consistent with the submitted facility sketch/floor plan. The exterior passageways were clean and clear of any obstructions. There are bodies of water on the premises at the time of the visit, but the pool is fenced and locked. At 12:55 p.m. LPA conducted the pre-licensing inspection tool. On 12/21/2021 at 3:30 p.m. Comp III was conducted. No corrections are needed at this time. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. A copy of the report will be emailed.