Pre-licensing visit·June 21, 2023

Licensing Program Analyst (LPA) Vincent Moleski arrived announced to conduct a prelicensing inspection at this home. LPA Moleski met with Salote Lewis and explained the purpose of the visit. LPA Moleski reviewed Lewis's application documents, fire clearance and floor plan. The home is cleared for six non-ambulatory residents. Lewis's administrator certificate number is 6062098740 and it expires 8/8/24. LPA Moleski toured the home with Lewis and inspected common areas, kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 69 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature was tested and measured 110 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked closet in a caregiver room for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski conducted Component III Orientation with Lewis. No deficiencies were observed during this visit. Prelicensing is complete for this applicant. An exit interview was conducted and a copy of this report was left with Lewis.