Pre-licensing visit·November 20, 2024

At 9:15 a.m., Licensing Program Analyst (LPA) Evelin Rios conducted a Pre-Licensing Inspection with the administrator, Denise Martin. This is new application for a Residential Care Facility for Elderly (RCFE). A fire clearance was approved on 06/26/2024, for six (6) non-ambulatory residents for a total capacity of six (6). A tour of the physical plant was initiated at approximately 09:25 a.m. and the following was observed: COMMON AREAS: These included living room and a dining room. The living room was equipped with furniture, a television, couches. There is a fireplace secured with a screen in the living room. The dining area has a dining room table to accommodate six (6) residents, a sofa and a piano. There were no visible immediate hazards. The facility has hard wired and battery operated smoke detectors through out the facility. At 9:38 a.m., smoke alarms and carbon monoxide detectors were tested and observed operational. OFFICE: There is an office space located in the living room. Resident and staff records will be maintained locked in a filing cabinet. KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, gas stove, microwave, and dishwasher. There is an adequate supply of seven (7) days nonperishable food. There is an adequate amount of table ware for the capacity of the facility. Knives and other sharps will be locked in a kitchen cabinet. Cleaning products and Chemicals are kept locked under the kitchen sink, inaccessible to residents in care. The fire extinguisher was located by the kitchen and in the living room. BEDROOMS: The facility has four (4) bedrooms. The applicant furnished all clients' bedrooms with beds, night stands, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. (Continue on LIC809-C) LAUNDRY ROOM/GARAGE: The washer and dryer is located in the laundry room accessible to residents. LPA observed all chemicals are kept locked in cabinets above the washer and dryer. The garage is accessible to from the laundry room. The garage is used for storage of the emergency food, water and facility supplies. BATHROOMS: The facility has two (2) bathrooms and were observed to have the proper fixtures, grab bars, non-skid mats, and trash cans with closed lids. The hot water delivered in the bathroom was measured at 1:10 p.m. to be at 119.2 degrees, within regulation. MEDICATIONS: The medications be centrally stored in on of the laundry room cabinet locked, inaccessible to residents. Facility has a First-aid kit and current manual. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home were clear of obstruction. The backyard of the facility is properly fenced, has a covered patio and backyard furniture to accommodate six (6) residents. There is no body of water. In addition to the Pre-Licensing inspection, a Component III power point presentation was also conducted with the administrator/applicant representative. Pre-Licensing is complete and this facility has no deficiencies. 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. Exit interview conducted and copy of this report signed and delivered to the Administrator.