Pre-licensing visit·June 23, 2021

On this day Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit for the purpose of conducting a Pre-Licensing visit. LPA was greeted and granted entry into the facility by Administrator Bahira Hanna and explained the reason for the visit. LPA toured facility with Administrator Bahira Hanna. Fire clearance approval was received on 05/24/21. Facility is a single story 7 bedroom (6 rooms for residents and 1 for caregiver) and 3 bathrooms. There are 4 residents in care. Residents observed watching TV in living room. All residents rooms had the required elements as well as restrooms stocked with soap and paper towels. LPA observed one fire extinguisher mounted and charged. There are 10 Smoke detectors which were tested operational. Sharps, toxins and cleaning supplies will be stored in a locked storage unit inaccessible to clients. Facility has required Department postings. LPA observed copy of Administrators Certificate expiring 8/20/2021. Facility has ample supply of linens and towels . Facility has emergency food and water supply. Stove and refrigerator are operational. Facility water temperature tested and recorded at 105.0 degrees F. Facility provides games and exercises for residents. Facility has a first aid kit with manual present at the facility. LPA observed completed emergency disaster plan. Facility has secured location for medications and facility files. LPA observed the facility perimeter is secured by brick wall with self latching gate. LPA observed ample shading and seating. Component III Orientation was waived during this pre-licensing visit due to Administrator having multiple facilities.The pre-licensing visit has been completed. This location is ready for licensure. No deficiencies noted during todays visit. An exit interview was conducted with Administrator Bahira Hanna and a copy of this report was left at facility.