Pre-licensing visit·May 19, 2022

Licensee Program Analyst Jason Lund met with applicants and Licensee Maria Payla and Peter Yu to conduct a Pre- Licensing inspection for this new elderly care home applicant. LPA toured the facility including common areas, resident bathrooms, kitchen, dining room, laundry, storage, and outside yard area. Requested capacity is 5 clients. The facility is clean and in good repair and no odors were detected in areas toured. No hazards were noted in courtyard areas, hallways, doorways, etc. No equipment was stored in public areas. Fixtures and furniture all appear to be in good condition. Cleaning solutions are stored separately from food. Handrails are present in all shower and toilet areas, are secured. Room temperature was comfortable in facility. There are no bodies of water on the premises. A Fire Clearance was granted for 5 non-ambulatory clients. Adequate number of bedrooms/apartments for capacity requested. Physical plant appears consistent with facility sketch. Facility has supply of bedding and towels. Furniture appears appropriate in bedrooms. There is adequate closet/drawer space available. There are plenty of bathrooms for number of residents. Non-skid mats will be purchased for the two showers. Emergency lighting available. Kitchen appears to be clean, well-supplied with equipment. Cooler/freezer appear to be at appropriate temperatures. First aid supplies available in several locations. Laundry equipment present, working telephone, emergency lighting. Component III was provided. LPA reviewed Personnel Policies, Abuse Reporting Procedures, In-Service Training and Medications Procedures. Exit interview conducted and copy of this report given to Ms. Payla.