Pre-licensing visit·August 3, 2022

Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in order to conduct a pre-licensing visit. LPA was greeted by the facility administrator upon entry and had his temperature taken and covid -19 protocols taken before being allowed entry. This facility application is a change of ownership and there were 3 residents at the time of the visit. The LPA was able to tour the home inside and out. There are 5 bedrooms, of which 4 will be used for residents and one will be a staff room. LPA did observe that the facility sketch did indicate that room 5 is a private resident room, however the administrator stated that this is an error and will be used as the staff room. LPA was able to check the water temperature and it measured at 105 degrees F. The smoke alarms and carbon monoxide detectors were tested and functioned properly. Component III Conducted. Pre-licensing Inspection tool review all eleven inspection domains, no deficiencies were observed. Licensee will submit an updated physical plant sketch to CAB. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the 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. You are to inform your LPA once you receive your first resident. Exit interview conducted. Report signed and delivered.