Pre-licensing visit·July 16, 2025

Licensing Program Analyst (LPA) Abeye Duguma conducted an announced Pre-licensing visit at 10:15 AM and met with administrator, Ruskie Ragasa. This is a single-story property. Fire Clearance is approved for five (05) non-ambulatory and (01) one bedridden resident. The common areas were appropriately furnished. LPA observed entertainment equipment and games for activities. LPA observed a fireplace with appropriate screen. Facility has five (05) bedrooms, three (03) bathrooms. Four (04) bedrooms are private and one (01) is semiprivate to be used for residents only. The facility has adequate linen. Resident bathrooms have properly installed grab bars and showers have non-skid mats. Hot water temperature measured 112.9ºF. All resident bedrooms were adequately furnished. The linens were stored in the storage space located at the end of the hallway. Towels and washcloths will not be shared. LPA inspected the kitchen and observed the stove and refrigerator to be clean and working. Facility has sufficient emergency food supplies and non-perishables. Sharps are stored in a locked kitchen drawer. Smoke detectors and Carbon Monoxide detectors were checked and function properly. Facility has a fully charged fire extinguishers located in the common area, purchased 03/24/2025. LPA advised the Administrator to retain the receipt of the fire extinguisher, identifying the purchase date to ensure the time frame of annual inspection. First-aid kit is complete. All toxins locked away. (CONT on LIC809-C) LPA observed a washer and dryer in the garage. There is sufficient outdoor space with seating and a shaded area with proper furniture for outdoor use. There are no bodies of water on the premise. 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 noted during this visit. Exit interview was conducted and a copy of the report was issued.