Pre-licensing visit·July 3, 2025

On 07/03/2025, Licensing Program Analyst (LPA) Pang Lee arrived at the facility and met with the applicant Tevita Kaloulasulasu and licensee Julie Nonu. The purpose of today's visit is to conduct a follow-up inspection related to the Pre-Licensing visit that took place on 07/01/2025. During that initial visit, several items were identified as needing correction to bring the facility into compliance in order to proceed with the licensing process for a Change of Ownership. According to applicant Tevita, the facility will have a live-in staff and will continue to provide 24-hour care, seven days a week. The following deficiencies observed during the previous visit have been corrected: · An updated facility interior sketch accurately reflected staff and resident rooms, as required by the approved fire clearance, was submitted via email to LPA Lee on 07/03/2025. · The closet door in Bedroom #7 was observed to be in good repair. · Closet doors in Bedrooms #1 and #3 were observed to have knobs installed, allowing for easy use by residents. · Review of personnel records showed that S1’s LIC 501 has been completed and is now up to date. · Records confirm that S2’s LIC 501 has been completed. Additionally, the Health Screening and TB test were completed on 07/01/2025. Continued LIC 809-C During today’s visit, LPA Lee reminded the applicant that any changes to the interior or exterior of the facility must be pre-approved by both the Department and the Fire Department. LPA Lee also introduced the Technical Support Program (TSP) to the applicant, Tevita, who expressed interest in participating in the program. LPA Lee informed the applicant that a referral to TSP will be completed once applicant is licensed. The applicant has successfully passed the pre-licensing component of the application process. Component III was also reviewed and completed with the applicant. LPA will notify the Centralized Applications Bureau (CAB) that the pre-licensing has been completed and approved. An exit interview was conducted, and a copy of this report was provided to the applicant Tevita.