Pre-licensing visit·May 10, 2024

Licensing Program Analyst (LPA) Sabrina Calzada arrived announced to conduct a pre-licensing inspection at 2:00 pm on 5/10/24. LPA met with Balwinder Rai, Administrator. There is a pending license for (6) residents, (3) of whom may be bedridden and (3) may be non-ambulatory. There are currently no residents present as this location is not currently licensed. LPA and Administrator toured the interior and exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (4) resident bathrooms, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting throughout. The bathrooms have the necessary grab bars, non-skid flooring, soap, paper towels and 20-second hand-washing poster. LPA observed 7+ day non-perishable food, dishes, flatware and cooking pans in the kitchen. There is an emergency supply of food and water on site. Sharps, toxins and medications are locked in the kitchen. Hot water measured 116*F in the kitchen and the inside temperature measured 72*F. Fire extinguishers were last serviced on 12/21/23 and smoke/monoxide alarms are in working order. The fire door also closes automatically when the alarm is activated. There is a complete First Aid kit on site with additional supplies on hand as well as paper supplies and PPE. LPA observed sufficient linens/towels/blankets. LPA observed various required postings posted, including the Emergency Disaster Plan and Theft & Loss Policy. LPA observed games/activities and an operating land line. All exit doors have alarms. There is patio table with chairs being delivered on 5/14/24. There is one exit gate in the backyard. LPA observed (6) resident binders with dividers and staff folders prepared also. Medication records are electronic but hard copies will be kept also. Administrator certificate #6058964740- exp 3/22/25. Component III was reviewed during today’s inspection. Pre-Licensing is complete and this facility has no deficiencies. Exit interview. Copy of report left at facility. LPA to notify to the Centralized Applications Bureau.