Pre-licensing visit·August 20, 2021

LPA Garcia conducted this announced prelicensing visit. LPA toured with MARIA ANGELICA SOUXOUAY, Administrator. This facility has a fire clearance for six non-ambulatory and six total. Hospice waiver for 6. This facility has two private and two shared resident rooms to the left of the main entrance. There is separate staff living quarters for onsite Administrator. There are 3 ramps available for emergency exits for residents. From the main entrance is an open entry welcome area into the dining room and kitchen. Off the open area is an additional seating area for residents with an attached bathroom. From the kitchen is an additional half bath then entry into the garage with the laundry, dryer, and extra storage. There is a common bathroom accessible to three rooms. There is a private bathroom attached to one of the single occupancy room. Carbon monoxide in hallway and central area. Fire alarms in all resident rooms and central area. Staff and client files are locked in closet area in front centralized office. All cabinets/ closets have keyed locks. The backyard was inspected and there is one gate on south side of the facility. The kitchen was inspected. There is a locked cabinet in kitchen for sharps. There is a locked cabinet that stores the medications. Refrigerated medications will be stored in clear lock box in garage fridge. Controlled medications in lock box in lock cabinet Both front and backyards are well maintained. There are audio alerts on all exits. Each resident has a call system that alerts the caregivers. Component III orientation completed and certificate posted. The Administrator has 5 years of licensing experience in both ARF and RCFE. Administrator Certificate exp. 6/30/21 with Conditional extension. LPA is going to submit this report to the applications specialist for review.