Pre-licensing visit·November 1, 2024

Licensing Program Analyst (LPA) Tyler Reyes conducted a pre-licensing visit. LPA met with applicant Administrator Liza Trice. An intial application was submitted to Community Care Licensing Department (CCL) for an Residential Facility for the Elderly age range 60 and over. Approved for six (6) non-ambulatory. Hospice waiver granted for five (5). The physical plant was toured with Administrator Liza. The following areas were inspected during the tour of the physical plant with Administrator Liza: Common areas, living room, dining room, kitchen, laundry room, three (3) shared resident bedrooms, two (2) restrooms, staff office, family room, front yard, and backyard. Resident bedrooms have the required furniture with sufficient closet space. Restrooms were clean, toilets and water faucets worked properly and included all functional fixtures such as secure grab bars. Shower were free of mold/mildew and non-skid mat in place. Water temperature was measured in restroom #1 at 106.8 degrees F and restroom #2 measured at 106.3 degrees F. which meets Title 22 Regulations. A locked storage area for central storage of medication were observed. The walls, ceilings, floors, and areas around the facility were clean and in good repair. Fire extinguisher was observed in the facility. All appliances in kitchen were observed to be clean and operational. The sharp knives are in a locked cabinet that is inaccessible to residents. Smoke detectors and carbon monoxide detector were observed throughout the facility and operable. Doors, exits, hallways, and passageways were clear and free of obstruction. The backyard has a shaded area. The home does not have a pool or any large bodies of water. All necessary postings were observed to be posted in appropriate places. A current disaster and mass casualty plan is maintained at the facility. An operating telephone was observed on the premises, which is easily accessible and available for resident use. First aid kit were observed which included all required supplies. (Continued LIC 809-C) No outstanding or pending items were observed by LPA requiring additional pre-licensing visits. LPA will notify the assigned Centralized Applications Bureau (CAB) Analyst of the completed pre-licensing facility evaluation visit conducted, which included the Component III Orientation. Per Administrator Liza the insurance company will not provide Liability Insurance until licensed. LPA Reyes advised Administrator Liza once Liability Insurance is obtained to forward document to CAB analyst. LPA Reyes informed Administrator Liza that once licensed facility is required to have a current Liability Insurance document or will be subjected to citation. Exit interview conducted and a copy of this report was provided to Administrator Liza