Pre-licensing visit·May 27, 2021

Licensing Program Analyst (LPA) K. Hiratsuka, arrived at the facility announced on 05/272021 to conduct an announced prelicensing visit. LPA met with Applicant/Administrator Marina Iancu, and explained the purpose of the visit. Prior to initiating the prelicensing visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted applicant and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by Administrator at the front door. This facility has a fire clearance for six non-ambulatory residents. This facility has six private resident rooms and an office/licensee living area on the second floor. The main entrance opens to a small foyer. There is a private resident room to the left and right of the main entrance. The is a hallway in front of the main entrance that leads to three private resident rooms and a full common bathroom. The largest room at the end of the hallway has an exit to the outside and a full private bathroom. To the right of the main entrance past the resident room is a door leading to the main common area that has the kitchen, dining, and living room. To the left and slightly across from the kitchen is a short hallway that has the sixth private resident room that has an exit to the outside, full common bathroom, laundry room that has a door leading to the garage, and the staircase that leads upstairs. The garage is going to be used for storage. Administrator stated there is going to be awake staff at all times. The backyard was inspected. There is a locked shed and gate leading to the front yard on the same side as the garage. There are locked cabinets in the kitchen for sharp knives. The oven has a lock built into it so the knobs do not have to be removed when not in use as long as the lock is turned on. The medications are going to be stored in a locked closet. LPA waived the component III orientation because Administrator already operates another facility. Multiple topics were discussed during this visit. This facility meets regulations. LPA is going to submit this report to the applications specialist.