Pre-licensing visit·November 26, 2024

Licensing Program Analyst (LPA) Angela Barutyan conducted a pre-licensing visit to the facility noted above at 10AM. LPA met with Applicant Jagdeep Singh and Applicant Representative Ravleen Kaur. The applicant has obtained fire clearance for a total capacity of six (6) residents. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The facility is one story. The facility has six (6) private resident bedrooms and one (1) staff bedroom. All resident bedrooms are cleared for bedridden. The hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. LPA observed one (1) fire extinguisher to be fully charged and purchased on 03/01/2024. LPA toured the kitchen area at approximately 10:02AM. The hot water temperature was measured in the kitchen sink, and it measured 108.1 degrees Fahrenheit. Appliances and all equipment appear to be clean and in good repair. The kitchen has a sufficient supply of plates, cups, cookware, and utensils. Kitchen knives and sharps will be locked in a drawer by the sink. LPA observed sufficient non-perishable food supply. Resident bedrooms are equipped with clean mattresses, pillows, and bedding. Bedrooms have sufficient lighting. There is a sufficient supply of linens, including blankets, bath towels and wash cloths. The facility has six (6) bathrooms for resident use. All bedrooms have an attached half-bathroom except for Bedroom #2 which has a full bathroom adjacent in the hallway for resident-use and showers. Bathrooms contained appropriate non-skid surfaces and grab bars. Hot water temperature was measured in all bathrooms, and they measured between 105 – 120 degrees Fahrenheit, which is within the required range. LPA observed trash cans with tight fitting lids at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809C... The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. LPA observed enough seating for six (6) residents at the same time in the dining room table. A working telephone is present. There are activity supplies in the living room. There is one (1) fireplace which was observed adequately covered. Night-lights were present in the hallways. Medications will be stored and locked in a cabinet in the kitchen. Facility records and First aid kit will be by the office area adjacent to the kitchen and staff bedroom. First aid kit was observed to have bandages, thermometer, scissors, tweezers, and a current first aid manual. The garage is attached to the office area and is kept locked and inaccessible. Additional cleaning supplies, toxins, a washer and dryer, detergents, disinfectants, cleaning supplies, and an additional refrigerator and freezer were observed in the garage. There will be no firearms/ammunition stored on the property. The facility has required postings, including Emergency Exit Plan, Licensing Complaint Poster, Resident Personal Rights, and Theft and Loss Policy. The exterior passageways were not free of obstructions. Applicant stated they will remove obstructions from pathways. There are two (2) side gates, one (1) will be used for emergency use. Emergency side gate did not self-latch or self-close. There are no bodies of water on the premises at the time of the visit. LPA observed the backyard, which has a covered outdoor area with a table and chairs for client use. There is a shed containing additional supplies; the lock will be repaired. Cameras were observed in the outside perimeter and in common areas. Cameras do not contain an audio component. Auditory exit alarm in the hallway was missing batteries and will be replaced. Physical plant is consistent with the submitted facility sketch/floor plan. Comp III conducted with Applicant and Applicant Representative. Report Continued on LIC 809C... Report Continued from LIC 809C... Pre-Licensing is incomplete with deficiencies to be resolved by 12/10/2024. A follow up Pre-licensure LIC809 will be generated upon resolution of deficiencies. The following needs to be completed prior to licensure: - Free outdoor pathways from obstruction - Side gate used for emergency exit to be self-latching and self-closing - Repair outdoor shed lock - Functioning auditory exit alarms 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. The report was reviewed, and a copy was provided.