Pre-licensing visit·April 26, 2022

Licensing Program Analyst (LPA) Jacob Williams arrived at the facility announced on 4/26/2022 to conduct a Pre-licensing referencing the infection control domain. LPA met with Administrator Benedicta Nwaukoni and explained the purpose of the visit. Prior to initiating the pre-licensing inspection, 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 and contacted licensee 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. LPA toured the interior and exterior of the facility together with Administrator. Areas toured include front room, living room, five (5) resident bedrooms, three (3) bathrooms, two (2) staff rooms, kitchen, laundry area, and backyard. Outdoors was clean, with adequate shading. Indoors has the requisite rooms for activity/den/dining. There are locked cabinets for personnel and client records. Facility has a first Aid kit and centrally stored locked cabinet for medication. Hot water temperature at 114*f. Smoke detectors functional. Fire extinguisher serviced. Toxins and chemicals are appropriately locked in a cabinet. No hazardous debris noted. Facility currently has six residents as it is operating as Maranatha Manor, undergoing change of ownership. Component III review completed. Facility is in significant compliance License pending approval. Exit interview conducted and copy of report left at the facility.