Pre-licensing visit·July 24, 2024

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility announced for the purpose of conducting a Pre-Licensing visit for a change of ownership and facility type. LPA conducted the visit with Applicant Joanne Casten. An initial application to operate a Residential Facility for the Elderly was received by the Department of Social Services on February 5, 2024, for a capacity of 6 residents. LPA toured the interior and exterior portion of the facility and observed the following accompanied by the Applicant Casten: Structure: Facility is a single story residential property comprised of four resident bathrooms and two full baths and one half bath. There is an attached two car garage, laundry room by the kitchen, and a backyard. Signal System: The facility does not have a signal system but is intending to purchase a signal system where the staff will be alerted in a central location. Bedrooms: The resident bedrooms had all required components, are spacious, and easily accommodates the residents’ furnishings. Bathrooms: Bathrooms were clean and operational. Grab bars were secure. Linens and Hygiene Supplies: Clean linens were observed to be fully stocked. Appliances: Stove burners, microwaves, washers, and dryers were inspected. Emergency Phone Numbers/Exit Plan: Posted in the kitchen area and readily available for review. Postings: The Complaint Poster (PUB475) was posted in the entry area of the facility. The Long Term Care Ombudsman Poster was not available. The Rights of the Resident Councils, Resident's Rights, Theft & Loss Policy, and the Activity Schedule were posted in the entry way or kitchen. Facility did not post a copy of the admission agreement. Food Service and Menu: Supply of seven day non-perishable and two day perishables were observed. The sample menu was available for review. The emergency food/water supply was stored in the kitchen pantry expiring in 2028. Smoke and Carbon Monoxide Detectors: Smoke detector and carbon monoxide alert systems were tested and found to be operational. Fire Extinguishers: Two fire extinguishers were mounted, fully charged, and serviced on March 13, 2024 which was unlabeled. One small extinguisher is in the company vehicle. Fire Clearance: Approved on March 13, 2024 for 5 non-ambulatory and 1 bedridden resident. Toxins and Sharps: Cleaning supplies, toxins, and sharps were secured. Water Temperature: Three resident bathrooms tested measuring at 113.9, 109.9, 103.5 degrees Fahrenheit. Medications, First Aid Kit & Manual: The First Aid Kit was checked and found to be in order. The First Aid kit is located in the kitchen area and in the company vehicle. The facility does not have the current edition of the First Aid manual. Resident and Staff Files: Resident and staff records will be maintained on site. Reading Material, Games, Equipment, & Materials: The facility had reading material and games present in the facility. Component III: Component III is waived due to the applicant previously having a licensed facility and having completed Component III. The following items need correction prior to licensure: Please repair by patching the holes in the ceiling by the half bath and the exit gate self-latches. Please deep clean the floor, kitchen, and kitchen appliances, sweep the backyard, wash the outdoor cushions and furniture to remove dust and cobwebs. Please remove or cover the exposed cable in the living room and remove the bricks/shelf in the exit passageway. Please obtain the current edition of the first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency and the Long Term Care Ombudsman Poster and post it in the entry way. Please post a copy of the admission agreement. Please label the inspection dates on the fire extinguishers. Facility does not appear ready for licensure. Any items noted above during today’s visit are to be corrected by Monday July 29, 2024 before 7:00am. An exit interview was conducted with Applicant Joanne Casten, and a copy of this report was provided at the end of the visit.