Pre-licensing visit·June 7, 2021

Licensing Program Analyst (LPA) K. Hiratsuka, arrived at the facility announced on 06/07/2021 to conduct an announced prelicensing visit. This facility is undergoing a change-of-ownership. LPA met with Facility Representatives Russelle and Curtis Robinson, Arminder Tahkar, and Jassmeet Singh 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 Facility Representative 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 Curtis Robinson. This facility has a fire clearance for 6 non-ambulatory of which one may be bedridden. The main entrance opens to a sitting area on the left. There is a hallway to the right of the main entrance that leads to the five private resident rooms, a full common bathroom, laundry area, and exit to the outside. There is a second full common bathroom at the start of the hallway. To the right of the main entrance is a sitting area that leads to the caregiver room. To the back of the facility is the main sitting, dining, office, kitchen, and next to the kitchen in a hallway is the sixth resident private room, full common half-bathroom, and door leading to the garage. Backyard was inspected. There is a a wood desk in the backyard and is maintained. There is a locked shed in the backyard. LPA waived the component III orientation because Facility Representatives 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.