Pre-licensing visit·May 8, 2025

Licensing Program Analyst (LPA) Teresa Camara conducted a pre-licensing visit to the above noted facility. The LPA met with administrator Gina Rozaner. This facility is currently operating under a different license (facility number 567609978 ). This is a change of ownership application. A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The facility is two-story. There are memory care and assisted living rooms on both floors. At 9:45 a.m., a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for a total capacity of 89 residents, of which 19 may be non-ambulatory and 70 may be bedridden. The facility has an automatic fire sprinkler system which was last inspected by the County Fire Protection on 3/5/2025. Fire extinguishers were observed throughout the facility and were last inspected 3/5/2025. The facility maintains smoke and carbon monoxide detectors and they are tested monthly by maintenance staff. Residents choose to bring their own furnishings to their rooms. All resident rooms are set up with beds, nightstands, lighting, chests of drawers, chairs and closet space. The beds have box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. In addition, no bedroom was used as a passageway to another room, bath or toilet. All rooms were free of odors. Window screens were clean and in good repair. There are no staff rooms at the facility. (continued on LIC809-C, page 2) (continued from LIC809, page 1) Each bedroom has a private bathroom. There are nine (9) shared bedrooms which have night-lights in the shared bathroom. There are grab bars in the showers and next to the toilets. All showers have non-skid mats. The hot water temperature measured between 114.1*F - 118.3*F, which falls within the allowable range of 105*F - 120*F. Resident and staff records are stored in the business office. Medications are centrally stored in locked medication carts in the Wellness Office along with the first aid supplies. Personal Protective Equipment (PPE) is stored in a room on the second floor. Residents do not have access to the commercial kitchen. Knives are stored in the kitchen. The kitchen was clean and the appliances were all functional. The walk-in refrigerator and freezer were well stocked with the perishable food supply. The freezer was maintained at 0*F and the refrigerator was at 40*F. Non-perishable foods are stored in the kitchen and in a locked room on the second floor along with an emergency water supply. The food supply is sufficient. There is a sufficient supply of dishes, utensils, and drink ware. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There are televisions in the media room in memory care. Activities are held inside the activity room and outside on the patios. The activities director posts a calendar of scheduled activities. The elevator is functional and permitted. Night lights were maintained in hallways and passageways to public bathrooms. The stairwells are equipped with emergency evacuation chairs. The memory care units have delayed egress on all doors and digital keypads to enter/exit the units. The physical plant is consistent with the submitted facility sketch/floor plan. The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have central air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. (continued on LIC809-C, page 3) (continued from LIC809-C, page 2) Staff do the laundry for the residents on scheduled days. Residents typically choose to supply their own linens, bath towels, and personal hygiene items (soap, shampoo), however the facility will supply these items if necessary. The facility also keeps extra incontinence supplies. There is a functioning telephone on the premises and residents are offered privacy to use the phone. All required postings were observed in both assisted living and memory care. Fireplaces were observed to have screens. The exterior passageways were clean and clear of any obstructions. There are covered patio areas and seating for both memory care and assisted living residents. There were no bodies of water observed. There were no deficiencies observed. 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.