Pre-licensing visit·June 11, 2024

Licensing Program Analyst (LPA) Sabrina Calzada arrived announced to conduct a scheduled pre-licensing inspection for a change in ownership. LPA met with Adina Sbingu, Administrator. This location is currently licensed for (6) non-ambulatory residents and has a hospice waiver approved for (3) residents. There is a pending license for (6) residents- (1) resident may be bedridden, and (5) residents may be non-ambulatory. There are currently (6) residents who reside at the facility and (3) were present during the inspection. No resident is currently under hospice care. Also present were staff, Nora Tokodi, and Marissa Carr, who were assisting in the kitchen. LPA and Administrator toured the interior and exterior of the facility including the common areas, (6) private resident bedrooms, (3) resident bathrooms, staff room, 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 a 20-second hand-washing poster at each sink. There is sufficient 2+ day perishable and 7+day non-perishable supply of food and sharps are locked in the kitchen. Toxins are locked in the laundry room and medications are secured in a separate cabinet near the office area. Hot water measured 114*F in a resident bathroom and the inside temperature measured 77*F. Fire extinguishers were last serviced on 8/1/23 and the smoke/monoxide alarms are in working order. The fire door is kept open by a self-release magnet attached to the wall, per code. There is a complete First Aid kit, PPE/paper supplies, and sufficient linens/towels/blankets. There are flashlights and night lights plugged in. There are multiple required postings posted near the front entrance, including the Emergency Disaster Plan and Theft & Loss Policy. There are games/activities and an operating land line. All exit doors have alarms. There is a shaded outside area with a table/chairs and two exit gates in the backyard. LPA observed one large staff binder for personnel records and individual resident files. The correct e-mail address and mobile number obtained and will be updated in the system. 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.