Pre-licensing visit·April 4, 2023

On 4/4/2023 Licensing Program Analyst (LPA) Tobola conducted a pre-licensing inspection and was greeted by Licensee Applicant, Ephram Parajillo and current Licensee, Alma Guba. This pre-licensing inspection is being conducted due to a change of ownership. Fire Clearance has been approved for 6 residents; 4 non-ambulatory and 2 bedridden with a special condition that only one bedridden client shall be housed at one time. There are currently 4 residents in care some of which with a diagnosis of dementia and none of which are on hospice. Licensee is in the process of re-admitting residents to the new facility ownership. LPA conducted a tour and inspection of the indoor and outdoor portions of the facility. Facility was found to be clean and comfortable temperature with bedroom doors free from obstruction. Fire extinguisher was recently service and charged on 3/27/2023. Smoke detectors and carbon monoxide detectors were tested and found to be operating. Emergency exits along the both sides of the facility have appropriate hardware and found to be unobstructed. Auditory alarms at all exits were in working order. Water measured between 109.4 & 116.6 degrees F in faucets used by residents which falls within regulation between 105 & 120 degrees F. There was an ample supply of linens, dishes and cooking supplies for resident use. In addition, there was a sufficient supply of cleaning supplies and hygiene products available for residents upon request. LPA observed adequate supply of both perishable and non-perishable food sufficient for the 4 residents in care. Toxins were observed to be secured in cabinets located in the staff quarters, under bathroom sicks and in outside shed area. Knives and other sharp items were also secured in a designated drawer in the kitchen. Medications are centrally stored in a locked cabinet in the staff quarters along with resident, staff and medication records all found to be secured. Licensee will be sending a copy of the updated liability insurance to CCLD. Component III orientation was conducted with the Licensee Applicant. The pre-licensing evaluation has been completed. License will be granted upon completion of a final review and approval from the Licensing Program Manager. This report was reviewed with applicant and a copy was provided to the Licensee.