Pre-licensing visit·June 15, 2021

Licensing Program Analyst (LPA) Elecia Weathersby conducted an announced pre-licensing inspection to the facility to complete the pre-licensing inspection and Comp III. LPA arrived at the facility at 9:27 AM and met with Licensee Milagros Azaula took LPA's temperature upon arrival and LPA filled out a COVID questionnaire. Licensee Milagros Azaula and Administrator Maria Lombardo accompanied LPA on a tour of the inside and outside of the facility. Currently there are 4 residents in care. Two rooms are currently shared by two residents in each. The home is a five bedroom, two bath home with a living room, dining room, and kitchen. Per the approved fire clearance, the licensee is approved for 5 non-ambulatory residents and 1 bedridden resident. All bedrooms are furnished with bed, night stand, dressers and have adequate lighting for residents use. The two empty rooms are also furnished with chairs. The facility currently has linens, towels and a sufficient amount of hygiene products for residents. The bathrooms have grab bars and non-skid mats installed. The water temperature was tested and measured between 110.7 to 117 degrees Fahrenheit. The smoke alarms and carbon monoxide alarm were tested and are in operating order. LPA observed one fire extinguisher present in the facilities dining area and fully charged. The kitchen was observed to have dishes, silverware and pots and pans. The knives were stored in a locked drawer in the kitchen. The medications, were in the locked hall closet. The chemicals are locked in a storage closet in the garage. The client files are stored in the living area and staff files are also stored and kept in the cabinet in the living area. The backyard was observed to be fully fenced with an unlocked gate. The facility does not have a pool or jacuzzi. LPA found all facility features to be in compliance and in line with Title 22 Regulations. An exit interview was conducted and a copy of this report was reviewed with and provided to Licensee Milagros Azaula.