Pre-licensing visit·June 8, 2022

Licensing Program Analyst (LPA's) Ruth Wallace and Renee Campbell conducted announced Pre-Licensing visit. LPA's explained purpose of visit at facility with Licensee, Administrator Certificate posted and expires on 09/08/2022. No hospice residents at this time. Current census is 6 residents. LPA's and staff toured facility and yard, spoke with residents and Licensee. All smoke detectors were tested and functioning. There are no pools or bodies of water at the facility, Hygiene items present. Hot water was tested and measured 108.2 degrees F, within the Title 22 regulation range of 105 to 120 degrees F. Grab bars/ non-skid mats present in bathrooms. Bedrooms appropriately furnished with beds, night stands, lights, dresser and closet space. Food supplies reviewed, there appears to be an adequate supply of 2 days perishable/7 days non-perishable food present. Toxic substances are locked in a storage area in the garage. Staffing appears adequate for resident needs; administrator present in facility sufficient hours/week to meet needs. Dangerous items locked/stored safely. Medications kept in locked cabinet in hallway closet. LPA's reviewed staff and resident files Employees have had at least 6 hours of initial training in medication administration. All current employees have criminal record clearance. Resident files each contain an admission agreement and physical exam. Disaster Plan posted, Medications appear to be given as per physician direction. There were no deficiencies observed during the course of this Pre-licensing visit. Comp III will be waived at this time and facility is ready to be licensed. Exit interview conducted with licensee and a copy of report given at the conclusion of the visit.