Pre-licensing visit·January 27, 2022

Licensing Program Analyst, Kathrina Chin made an announced visit for a pre-licensing evaluation. LPA met with Kim Bhatia, Administrator. The facility has 5 bedrooms and three full bathrooms and is a single story with a two car garage. The inspection is as follows: A fire clearance was granted on September 15, 2021 for 6 non-ambulatory of which one may be bedridden. This facility has submitted a hospice waiver request for 5 residents. LPA toured the facility, interior and exterior, including all resident bedrooms. Hot water were tested in a bathroom and observed to be 108 degrees Fahrenheit. Fire extinguishers were mounted and charged. Smoke detectors were centrally wired throughout and have been checked by the fire department. Carbon monoxide detectors are operational. There is a sufficient supply of linens. Bedrooms are appropriately furnished. There is sufficient lighting. There are non-skid strips in the showers. There was one locked medication closet and there is first aid kit in the kitchen cabinet. There were several locked closets for storage of toxins, cleaning equipment, PPEs in the garage. All exit has auditory devices. The kitchen area was checked and there is a sufficient supply of food items. There were emergency food supplies and water. LPA observed activity calendars, theft and loss policy, residents rights, admission agreement, and emergency plans were posted including the Ombudsman and Let Us Know posters. LPA reviewed the outdoor area and with outdoor furniture. A Component III was completed during the visit with Kim Bhatia, Administrator. LPA reviewed Personnel Policies, Prohibited Health Conditions, Fingerprinting, Abuse Reporting Procedures, In-Service Training and Medication Procedures. (Continued LIC 9099C) It appears that this facility meets the requirements for licensure. Both the license and the hospice waiver will be granted upon final review and approval from the Central Applications Bureau. An exit interview was conducted with Administrator, Kim Bhatia and a hard copy of this report was provided.