Pre-licensing visit·May 17, 2023

On 5/17/23 Licensing Program Analysts (LPA)/Alfonso Iniguez conducted a pre-licensing evaluation for an RCFE (Residential Care Facility for the Elderly) facility type. Today’s pre-licensing evaluation was conducted with licensee/Adam Zenou. The licensee has applied for a license to serve (174) age range 60 and over adults. The fire clearance is approved for (150) non-ambulatory and (24) bedridden residents. LPA toured facility Kitchen, Dining Room, Living Room areas, (8) Bedrooms, (8) Bathrooms, Garage, and Patios with shaded areas. LPA observed sufficient storage areas for kitchen supplies, linens, medications (secured) and chemicals (secured). LPA observed the following during this visit: MEDICATIONS There is a locked centralized storage area for Resident medications. PHYSICAL PLANT LPA observed the facility is clean, sanitary, and in good repair. Indoor and outdoor passageways, stairways, open areas, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair. Facility temperature is between 68° degrees and 85° degrees. Open patios, and areas of potential hazard are well-lit. Carbon monoxide/Smoke detectors operate properly. BEDROOMS No client bedroom is a passageway to another room, bath, or toilet. There is a bed for each client with a mattress, mattress pad, bedsprings, and pillow(s) which are clean and in good repair. There is dresser and closet space for each client that includes at least two (2) drawers of dresser space per client. There is a chair and lamp for each client and at least one (1) nightstand per two (2) clients. CONTINUE ON LIC 809C BATHROOMS There are plenty toilets and washbasins for clients, family, and personnel. There are plenty showers for clients, family, and personnel. Hot water temperature is between 105°-120° degrees Fahrenheit. Bathrooms are located inside client bedrooms and common areas. Public restroom calling system is operational. SUPPLIES There is a sufficient supply of clean linens to permit weekly changing or more of client top sheets, bottom sheets, bedspreads, blankets, pillowcases, mattress covers, bath towels, hand towels, and washcloths. FOOD SERVICE Dining room is near kitchen. Refrigerator and freezer are clean and have the capacity to store at least two (2) days of perishable foods. There is storage for seven (7) day supply of non-perishable food. There are enough tableware, tables, dishes, and utensils. All equipment, dishes, and utensils are clean and well maintained. All kitchen, food storage, and preparation areas are clean. RECORDS There is confidential storage for personnel records at the facility. There is storage for Resident confidential information and records at the facility. ADMINISTRATION The emergency exiting plan and emergency phone numbers are posted. Client Personal Rights are posted. Posting both sides of the Personal Rights form LIC 613 meets this requirement. Facility Visiting Policy is posted. Licensing Complaint Poster is posted. There is space available for resident council meetings and resident council postings. ACTIVITIES There is an outdoor activity space with a shaded area and furnished for outdoor use. There are at least 3 common areas available to clients for visitors. There are activities scheduled during the current month. CONTINUE ON LIC 809C MISCELLANEOUS There are first-aid supplies to include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual. There is space and equipment for laundry. There is a space for clean linen storage and a separate space for soiled linen. There is an operating telephone available to clients. Emergency lighting and supplies to include flashlights with batteries. LPA observed a sign-in/sanitation station at the facility entry. There is hand sanitizer located at the entrance of the facility. Facility has screening process for all visitors, sanitizer/soap, paper towels, and additional PPE supplies are stored inside the facility. During this pre-licensing inspection, LPA Iniguez did not find corrections are needed. LPA conducted the Component III Orientation with the Licensee and copy of this report was provided. A copy of the facility evaluation report will be available to the Central Applications Unit (CAU) for review.