Pre-licensing visit·January 25, 2022

Licensing Program Analysts (LPA) Diaz conducted a pre-licensing visit to the facility above at 12:08pm. LPA met with Jennifer Villaros The applicant has obtained fire clearance for (5) non-ambulatory and (1) bedridden residents, for a total capacity of six (6) Residents. Beginning at 12:13pm, LPA inspected the proposed facility for Fire Safety, Personal Accommodations, and Food Service. 2 exterior screen doors are in good repair but need to be realigned on the door track. All hard-wired smoke alarms were functioning properly at this time. The carbon monoxide detector was functioning. LPA observed one fire extinguisher to be fully charged. Paint, windows, blinds, and floors are in good repair. The common living and dining areas are clean and properly furnished. A working telephone is present. The facility has a comfortable temperature of 72 degrees. The proposed facility has 5 resident bedrooms total. 4 resident bedrooms were furnished and contained beds, chairs, bedside tables and lamps. 1 resident room was missing a dresser. All beds have sheets, pillows, and mattress pads. There is also an ample supply of linen, towels and paper products. The proposed facility has (2) full bathrooms for resident use. The water temperature in 2 bathrooms read at 123. degrees. LPA observed night-lights present in the main hallway.The kitchen contained a sufficient supply of dishes, glasses and utensils. A seven-day supply of non-perishable food is present, as well as, a seven-day supply of water. A locked medication cabinet and First Aid Kit was observed to be complete. There is space to lock chemicals in the garage, under the bathroom sink and kitchen sink. Sharp items are stored in a locked kitchen drawer. The laundry room is located in the garage and supplies will be stored in the locked garage cabinets. The building and grounds are free from hazard The licensee must completed the following below: 1. Provide Dresser in bedroom 4. 2. 2 exterior screen doors need to be realigned on the outside track 3. Water temperature needs to be between 105 and 120 Degrees. The report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted and report issued.