Pre-licensing visit·December 28, 2021

Licensing Program Analyst (LPA) Diaz conducted a pre-licensing visit to the facility above at 10:50am. LPA met with applicant Aprillyn Soriano and Consultant Debra Ermac and Administrator Cheryll Ate. The applicant has obtained fire clearance for (6 )non-ambulatory and (4) bedridden residents for a total capacity of (6) residents. Beginning at 11:00am, LPA inspected the proposed facility for Fire Safety, Personal Accommodations, and Food Service. All smoke alarms and carbon monoxide detectors were functioning properly at this time. LPA observed two screens windows to be torn and needed repair. LPA observed one fire extinguisher to be fully charged and newly purchased. Paint, windows, blinds, and floors are in good repair. There are no firearms on the premises. The common living and dining areas are clean and properly furnished. A working telephone is present. The facility has a comfortable temperature of 71 degrees. The proposed facility has 5 resident bedrooms total. There are 4 single-occupancy bedrooms and 1 double occupancy bedroom. 4 resident bedrooms were furnished and contained beds, chairs, bedside tables and lamps. All beds have sheets, pillows, and mattress pads. 1 double occupancy bedroom was missing a night stand. There is also an ample supply of linen, towels and paper products. The proposed facility has (3) full bathrooms for resident use. Bathroom 3 needs new light bulbs and a repaired light switch. LPA observed a night-light present in the main hallway. Hot water measured at 112 degrees Fahrenheit at approx. 11:50am 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 and under the kitchen sink and in the laundry room. Sharp items are stored in a locked kitchen drawer. Laundry room is located next to the kitchen and supplies will be stored in the locked garage cabinets. The building and grounds are free from hazard. LPA and Applicant Aprilyn Soriano completed component III The following needs to be completed/proof submitted prior to the facility being licensed: 1. Two screen windows need to be repaired 2. Repair Light Switch and bathroom light bulbs 3. Complaint poster needs to be size 20 by 26 color 4. Missing night stand in bedroom 3 This 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.