Pre-licensing visit·June 10, 2024

On 06/10/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived announced to conduct a Pre-Licensing Visit. LPA Pascua was greeted by applicant, Kristine Aducayen and explained the purpose of the visit. The purpose of this visit was to conduct a Change of Ownership Pre-Licensing Visit. Current census was 6. A brief interview with Applicant Aducayen was conducted. This facility current holds 6 residents, of which 1 may be bedridden located in Bedroom #1. 5 out 6 residents may be non-ambulatory. This facility also holds a dementia plan and has a hospice waiver for 6. A tour of the facility was conducted. Smoke detectors and carbon monoxide was observed to be in good repair. LPA toured the office area which holds, resident, staff and medication. LPA reviewed 2 staff files and 2 resident files. Along with the applicant, the LPA reviewed, discussed and compared medication to medication dispensing logs. First aid kit was present and in compliance. The facility administrator holds a current certificate #6020119740 and expires on 09/08/2024. LPA toured the living room. dining room, and all other areas intended for resident use. Furniture and furnishings were in good repair. LPA toured the kitchen. LPA observed knives and sharps locked and made inaccessible. LPA observed a sufficient amount of 2 day perishable and 7 day non-perishable food supply. Fire extinguisher was observed to be last serviced on 03/09/2024 by River City Fire Equipment Company. LPA toured the outside area. Perimeter fence and gates were observed to be in good repair with no hazards present. Exit gate was observed and was in good repair. LPA toured 2 resident bathrooms. Hot water temperature was taken to ensure compliance within 105-120 degrees. LPA observed grab bars present in both bathrooms. LPA toured 6 resident bedrooms. Furniture and furnishings were observed to be sufficient to meet resident needs and were in good repair. Washer and dryer were identified in the hallway. Laundry detergent, cleaning supplies and other toxins were locked and made inaccessible. LPA also identified additional linens in a cabinets adjacent to the washer and dryer. This facility has been observed to be in compliance at this time. There were no deficiencies observed during the course of this Pre-licensing visit. Applicant has already conducted Comp I and Comp II. Comp III was reviewed with applicant. Exit Interview was conducted and a copy of this report was provided to the applicant at the end of the visit.