Pre-licensing visit·April 22, 2021

Licensing Program Analyst (LPA) Sabrina Calzada conducted a scheduled tele-visit on 4/22/2021 @3:30 pm with Nathan Condie, Executive Director and Kathleen Gilbey, Administrator Designee, due to current Covid-19 precautionary measures in place. The reason for the pre-licensing is due to a change in ownership. There are 66 residents currently residing at the facility. LPA and Executive Director toured the interior of the facility, including common areas, kitchen, (2) resident rooms, and outside courtyards The facility is a two-story building with separate memory care (M/C) and assisted living (A/L) units. The facility has a fire clearance for (89) non-ambulatory residents and (12) bedridden residents. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting throughout. LPA observed sufficient 7+day non-perishable and 2+day perishable supply of food in the kitchen and the freezer/refrigerator temperatures to be set at required temperatures. LPA observed the hot water measured at 118*F in two resident rooms. LPA observed a complete first aid kit in the medication room and that the fire extinguishers were serviced on 8/4/2020. Resident in A/L have a pendant to wear and residents in M/C have a pendant to use in the bathroom and there are egress doors within the M/C unit that are monitored (6) times a day. LPA observed a fountain that is against the wall in M/C patio that does not have any standing water and a fountain built within a concrete planter box in A/L patio. Activities are posted within each A/L and M/C unit. Vehicle maintenance records are maintained as well as resident and staff binders and training records. LPA observed the following posted at facility: Resident Personal Rights, a completed Emergency Disaster Plan for RCFE (LIC610E), See Something Say Something poster, Ombudsman poster, Facility sketch with evacuation route, Theft and Loss Policy, and Rights of Resident/Family Councils, and Non-Discrimination notice. Comp III was conducted during today's inspection. Pre-licensing is complete and this facility has no deficiencies. LPA to notify analyst in application unit of inspection being conducted. A copy of today's report tele-visit was emailed to the Executive Director on 4/23/2021. Administrator agree to sign and return a copy of the report to CCL and to keep a copy for the facility records.