Pre-licensing visit·July 8, 2022

Licensing Program Analysts (LPAs) Kruz Long conducted an announced visit to the facility for the purpose of a pre-licensing evaluation. An application was submitted on 03/14/22 for Initial License #198603550 for a Residential Care Facility for the Elderly to serve age range 60 and over. A tour of the facility contains 2 buildings: Building #1 has 2 floors, first floor containing a lobby, 5 offices, ballroom, staff break room, store, salon, 2 community men's restrooms, 2 community women's restrooms, pantry, mail room, kitchen, private dining room, dining room and a living room. Second floor is undergoing renovations used for storage. Building #2 contains 7 floors. First floor contains a medication room, activity room and 23 resident bedrooms each with it's own bathroom. From the second floor to the seventh floor: Each floor contains 24 resident bedrooms each with its own bathroom, laundry room, community restroom and an activity room. The following was observed: Passageways, walkways, driveways, steps and patios are free from obstructions. Front, back and side areas of free of hazards. Signal system in resident's bedrooms is operable. Resident bedrooms has all the necessary furnishings. Bathrooms have grab bars, working toilet, wash basin, bathtub/shower and non-skid tape/mats.The resident's bedrooms are spacious and easily accommodates the resident's furnishings. Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Fire Extinguishers are located though out the entire facility. Dishes, cups and flat ware were inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are stored and locked in the kitchen. Food supply adequately stored in the kitchen. Smoke detectors and Carbon monoxide detectors are operational. Stove burners, oven, microwave, washer, and dryer working are operable. Each refrigerator has a measured temperature of at least 45 degrees Fahrenheit for appropriate food storage. Freezer is at 0 zero degrees Fahrenheit. The residence is equipped with central air and heat. Toxins and cleaning supplies are stored in the second floor of Building #1. Water temperature tested in various resident bathrooms measured within Title 22 guidelines. Continue to LIC809C.... A first aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and current first aid manual. Staff and resident files are stored in the Activity office. Each floor has a land line readily available for resident use. The facility has board games, books, and other recreational materials for the residents use. There are no pool or large bodies of water on the premises. Fire clearance was approved on 01/28/22. Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within substantial compliance. During the pre-licensing inspection, LPA did not observe items which do not comply with applicable laws and regulations 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 Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to their application.