Pre-licensing visit·January 31, 2025

Licensing Program Analyst Abeye Duguma (LPA) conducted an announced Pre-licensing visit at 01:30 PM and met administrator, Sean Abalajon. LPA conducted an entrance interview with the Administrator. With the assistance of the Administrator, LPA conducted a facility tour of both the inside and outside. The facility was inspected for Fire Safety, Personal Accommodations and Services, Medication Procedures and Food Service. This is a single-story property. Fire Clearance is approved for six (06) non-ambulatory of which one (01) may be bedridden resident. Facility has six (06) bedrooms, of which five (05) are for residents and four (04) bathrooms. Resident bathroom has properly installed grab bars and shower has non-skid mats. Hot water temperature measured at 108.3ºF during the visit. All residents’ bedrooms were adequately furnished. The linens were stored in the storage space located in the hallway cabinets. The common areas were appropriately furnished and had adequate furniture. The LPA observed entertainment equipment and games for activities. The records were stored in a file cabinet located in kitchen nook. The first-aid kit is complete. At the time of the visit, facility had water, perishable and nonperishable food supplies should they admit a resident(s). LPA observed a fireplace that has appropriate screen. LPA inspected the kitchen and observed the stove and refrigerator to be clean and working. Sharps are stored in a locked kitchen cabinet. Smoke detectors and Carbon Monoxide detectors were checked and function properly. There are two (02) fully charged fire extinguishers located in the kitchen area and hallway. Fire extinguishers were certified on 12/06/2024. (CONT. on LIC809-C) LPA Duguma observed a washer and dryer in the laundry room at the end of the hallway to the right. All toxins were stored in a cabinet under the sink. There is sufficient outdoor space with seating and a shaded area with proper furniture for outdoor use. Facility has two (02) empty water fountains and a swimming pool with appropriate locked fencing. At the time of this visit the physical plant is meeting Title 22 requirements. The Component III completed with LPA. No health and safety hazard were noted during this visit. Exit interview was conducted and a copy of report was issued.