Pre-licensing visit·July 10, 2025

Licensing Program Analyst (LPA) Javier Prieto conducted an announced visit to the facility for purpose of a pre-licensing evaluation. An initial application to operate a Residential Care Facility for the Elderly was submitted to the Central Applications Unit (CAU) on 03/14/2025 for a total capacity of 6 non-ambulatory. Fire Clearance was granted 04/10/2024. LPA Prieto met with Patsara Chantharaseth- Administrator. LPA Prieto observed the following: Structure: Facility was a single story house with four (4) bedrooms, two (2) bathrooms, living room, dining area, office space, and kitchen area. Heating/Cooling System: Central heating and air conditioning systems. Bedrooms: All bedrooms were adequately furnished with bed, chair, large closets, appropriate linens, adequate lighting, and an operational smoke alarm and fire extinguishers. Bathrooms: Bathrooms have a working toilet, wash basin, and shower with an adequate supply of towels, toilet paper, and toiletries. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Cleaning supplies and knives/sharp instruments were secured in a locked cabinet and/or drawer. There was adequate room for food storage. Refrigerator/freezer were in working condition. There was adequate seating for meals. Living/Family room: Furnished with safe and adequate seating and furnishings. All items appear to be in good repair Linens and Hygiene Supplies: An adequate supply of linens was available. Laundry detergents and cleaning solutions were secured. Yards/Outside: There was a covered area with adequate seating for staff and clients. There were no obstructions. There were no bodies of water observed anywhere on the property. Garage: Garage was organized and free of obstructions. Emergency Phone Numbers, and Exit Plan: Let-Us-No poster and clients rights are posted. General items: LPA observed a working facility phone. LPA conducted COMPONENT III with the applicant during this Pre Licensing Inspection. This facility physical plant is prepared for licensure at this time. A copy of this report was discussed and provided to Patsara Chantharaseth- Administrator at the conclusion of the visit.