Facility-requested visit·October 3, 2022

Licensing Program Analysts (LPAs) Chinwe Nwogene conducted an announced case management visit to increase the capacity per licensee request. LPA met with Licensee, Annalisa Blancaflor and explained the purpose of the visit. At the time of visit there was three (3) residents and one (1) staff present. Licensee requested for a capacity increase from 4 residents to 6 residents. A Fire Clearance was approved on 8/26/2022 for six (6) non-ambulatory residents of which one (1) can be bedridden. Facility sketch on file shows sufficient square footage in the facility and activity rooms to accommodate the requested capacity. LPA Nwogene discussed the facility sketch with Licensee. Resident bedroom one (1) has been approved for one non-ambulatory client and one (1) bedridden client. Bedrooms #2,4,5,6 are approved for one (1) ambulatory or non-ambulatory client each. LPA Nwogene confirmed that bedroom one (1) has an exit to the outside of the facility, as well as a walk-in shower in the private bathroom. LPA Nwogene toured the interior/exterior of the building and visually inspected the resident bedrooms. LPA Nwogene confirmed that all identified shared rooms are large enough to accommodate the required furniture for two residents without inhibiting movement into and throughout the rooms. LPA Nwogene additionally confirmed that there are sufficient bathrooms in the facility to meet Title 22 requirements for ratio of residents to bathrooms. The physical plant is ready for increase in capacity. LPA will submit file for capacity increase approval. The final approval of capacity increase is contingent upon LPM's final file review. Licensee will be notified by LPA once capacity increase has been approved by licensing. If capacity increase is approved, new license will follow in the mail after phone notification by LPA with Licensee. An exit interview was conducted where this report was discussed and a copy was provided to Licensee, Annalisa Blancaflor.