Pre-licensing visit·May 7, 2026

Licensing Program Analyst (LPA), Regina Cloyd, conducted an announced visit to the facility for purpose of a pre-licensing evaluation. An application was submitted to CCLD for an initial license for a Residential Care Facility for the Elderly to serve residents age range 60 and over. The facility is approved for six non-ambulatory residents of which one may be bedridden. Structure: The facility includes one staff room, four resident bedrooms, two and a half bathrooms, living area, dining area, kitchen, laundry room, and an attached garage. There is a ramp in the front of the house and a ramp that wraps around the side of the house to the rear. Physical Plant: Facility is clean, sanitary, and in good repair. Indoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions and well-lit. All window screens are clean and in good repair. Bedroom 1 is for staff. Bedroom 2 and 5 are shared rooms for non-ambulatory residents. Bedroom 3 is private for a non-ambulatory resident. Bedroom 4 is private for a bedridden resident. All rooms have an appropriate number of beds, nightstands, lamps, closet space, and overhead lighting. Bathrooms: All bathrooms have a working toilet, wash basin, and shower/bathroom. There is one bathroom that will accommodate non-ambulatory residents in a wheelchair. The water temperature measured at 107-degree Fahrenheit. Linens & Hygiene Supplies: Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen stored in cabinet in the hallway cabinets. Emergency Phone Numbers, Exit Plan & Menu: The Emergency Disaster Plan with emergency phone numbers are posted & readily available for review in the living area on the cork board. The facility sketch and exit plan is in the living area. Two mounted fire extinguishers are in the facility. Food Service: Dishes, cups and flatware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are stored in a locked drawer. Smoke Detectors: Smoke and carbon monoxide detectors are operable and interconnected. There is a fire door between the living area and bedroom 1. Appliances: Stove burners, oven, microwave, and washer and dryer are working. There is one refrigerator in the kitchen and in the garage. The kitchen refrigerator has a measured temperature of at least 40 degrees Fahrenheit for appropriate food storage. Freezer is at zero degrees Fahrenheit. The residence is equipped with central air and heating. Toxins: Locked and stored in the laundry room. Continue to LIC809-C Medications, First-Aid Kit & Book: A first aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and current first aid manual, which are stored on a file cabinet in the dining area. Clients & Staff Files : Records of staff and residents will be stored in a locked file cabinet in the dining area. Reading Material, Games, Equipment & Materials: The facility has arts and crafts, board games, bingo, and karaoke for the residents' use. Pool/Jacuzzi & Pets: None Fire clearance: Rooms approved for non-ambulatory/bedridden, approval of delayed egress or delayed egress with secured (locked) perimeter was approved on 11/06/25. The facility exits do not currently contain delayed egress but sensory signals. The facility has a fence with self-latching gates. Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within substantial compliance. An exit interview was conducted and a copy of this report has been furnished to the applicant. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.