Pre-licensing visit·February 21, 2021

Licensing Program Analyst (LPA) Avelina Martinez contacted the facility via telephone to conduct a follow up correction pre-licensing visit on 02/21/2021 due to COVID-19 and pre-cautionary measures. LPA Martinez identified herself and discussed the purpose of the call and the elements of the pre-licensing visit with Drusilla Uwoghiren. Facility has a fire clearance for 6 non-ambulatory residents. Administrator, Drusilla Uwoghiren, will be the Administrator of this facility. The facility administrator’s certificate #:6044309740, and expires: 05/02/20201. LPA Martinez inspected the interior and exterior of the facility via virtual visit. The facility was observed to be in substantial compliance, and component 3 was completed with Drusilla Uwoghiren. The facility had an adequate food supply. The facility also has a sufficient supply of utensils, plates, and bowls. The facility's kitchen water temperature was 108.9 degrees. The facility has emergency food and water kit. The facility's living room and common room were furnished, and the facility has a public phone for residents. The facility's laundry room has a locked cabinet for cleaning supplies and has a sufficient supply of linens. The bathrooms are equipped with non-slip tub mats, grab bars, night lights, and hygiene products. The bathroom water temperature was 106 degrees. All bedroom were supplied with furniture and linens. All smoke detectors, carbon detectors, and fire extinguishers are in good repair and up to date. The facility has staff, resident, medication, and fire drill binders, which all are complete. The facility has a first aid kit, and the facility has an emergency disaster plan 610E. The exterior of facility has chairs in shaded area. The exterior has an emergency exit gate. Continued.. The applicant has passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. An exit interview was conducted with Applicant Drusilla Uwoghiren via telephone and a copy of this report was provided via email and an electronic email read receipt confirms receiving these documents.