Routine inspection (multi-day)·March 20, 2023

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of conducting a Annual Continuation. LPA was greeted at the door by Caregiver, Shella Pastore, and was granted access into the facility. During this Case Management-Annual Continuation, LPA interviewed staff and residents in care. LPA reviewed staff and resident files during this Case Management-Annual Continuation. LPA requested the following documents to be sent: LIC 500- Personnel Report LIC 308- Designation of Responsibility LIC 309- Administrative Organization LIC 400- Affidavit regarding Client Cash Resources Updated facility sketch Updated Emergency Disaster Plan (LIC 610E) Surety Bond Most up-to-date Liability insurance Control of Property Register of residents Copy of Administrator Certificate No deficiencies were cited during this Required 1 year inspection. Exit interview was conducted and a copy of this report was signed and given to the Caregiver.