Pre-licensing visit·May 6, 2025

On 05/06/2025 at 9:32AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an announced visit to the facility for the purpose of a Pre-Licensing evaluation. I met with staff, Maria Garcia. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 08/26/2024 for a total capacity of four (4) ambulatory residents. Fire clearance was granted on 11/12/2024. LPA observed the following: Structure : Facility is a two level house with two (2) resident bedrooms, one (1) resident bathroom, living room, dining area and kitchen. There was an attached two car garage in the front of the house. Heating /Cooling System: Central heating and air conditioning system installed with a central panel located in the hallway on the first level which controls the entire house. Bedrooms: Two (2) resident bedrooms are located on the first level per the fire clearance. All bedrooms are adequately furnished with bed, chair, closet, appropriate linens, adequate lighting and night lights were observed in the main hallway leading to residents' shared bathroom. . Bathrooms : The bathrooms has a working toilet, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. The water temperature was measured at 110 degrees Fahrenheit. Kitchen: The kitchen has an adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments will be kept in a locked cabinet in the garage. There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator/freezer were in working condition. Kitchen: There was sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry: Laundry room with washer and dryer was located on the second level of the home. Laundry detergents and cleaning supplies were observed in the laundry room and will be kept locked. Living /Family Room: There was a living/family room with a TV and adequate seating for all clients. Linens and Hygiene: An adequate supply of linens was stored in the resident's closets. Yards/Outdoors: There is sufficient covered seating area in the backyard and one shed for storage. There is a self-latching gate on the left side of the residence. All outdoor pathways were free of obstructions. Emergency Phone Numbers and Exit Plan : Facility sketches were observed posted in the main office area. There was one (1) fire extinguisher, two (2) carbon monoxide detectors and (10) smoke detectors which are working and in good condition. General items: Client records will be stored in a locked cabinet in the office area. First Aid kit with required components are located in the garage. Medication will be locked in a cabinet in the garage. Facility will make arrangements to have a telephone land line installed. Emergency water supply and food was observed. An exit interview was conducted and no deficiencies were cited. Component III was completed during this visit and a copy of this report was reviewed and provided to staff, Maria Garcia. .