Pre-licensing visit·February 21, 2023

Licensing Program Analyst (LPA), Natasha Persaud conducted a Prelicensing inspection. An initial application to operate a Residential Care Facility for the Elderly was received on 06/14/22 The facility was approved to care for four (4) Non-Ambulatory Elderly Residents. LPA was greeted and allowed entry into the facility by Administrator, Michelle Tuscano. LPA met with Applicants, Ira Jean and Candy Meneses and Licensee, Herminia Santos. Structure - The facility is a single story structure with 6 bedrooms and 4 bathrooms. There is an outdoor covered area for resident use. No bodies of water were observed. B edrooms Residents - Rooms #1-#4 may be used for Non-Ambulatory. Bedrooms Staff - There is 1 office and 1 break room. Bathrooms - All bathrooms have a working toilet, sink, grab bars and tub/showers with non-skid mats. Linens & Hygiene Supplies - Adequate supply. Emergency Phone Numbers, Exit Plan and Required Postings - Posted. Smoke Detectors and Carbon Monoxide Detectors- Interconnected and hardwired. Appliances - Stove burners, oven, microwave, washer, and dryer working. Toxins - Stored in a locked cabinet. Water Temperature - Measured at 119 degrees F. Medications- Centrally stored and locked in a cabinet. First-Aid Kit - Stored in a locked cabinet. Resident & Staff Files - Located in the office. Activities - Adequate supplies to include exercising, painting, and puzzles for resident's use. Fire clearance - Approved on 07/25/22 . Component III - Conducted at the Pre-Licensing visit. Information provided about how to operate the facility within substantial compliance. All items reviewed during the visit are in compliance. Prelicensing is complete and this facility has no deficiencies. Facility appears to be ready for licensure pending final review. An exit interview was conducted and a copy of this report was provided to Applicants, Ira Jean and Candy Meneses signature below confirms receipt of these rights.