Pre-licensing visit·July 15, 2024

LIcensing Program Analyst (LPA) Jill Nakagawa arrived for the purpose of conducting a Pre Licensing Inspection. LPA was met at the front door by Licensee, Robert Coleman, and was granted access into the facility. Fire Clearance approved for 8 nonambulatory, 2 of which may be bedridden. Paulin Pantig will be the Administrator, Administrator's Certificate # 7024304740, effective 01/07/2023 - 01/06/2025. LPA and Administrator Paulin Pantig toured the one story facility, which has 6 bedrooms, 3.5 bathrooms, and large family room and kitchen. LPA observed the facility to be clean and at a comfortable temperature of 74 degrees F with all exits free from obstruction. The fire department inspected the facility and found the Sprinkler System operational. LPA found the carbon monoxide detector to be operational during the inspection. The fire extinguisher was last charged on April 15, 2024 and was fully charged and operational. First Aid kit was inspected and found to be complete. Water temperature was 117-120 degrees and is within acceptable range of 105 to 120 degrees F. There was sufficient perishable and non-perishable foods located in the kitchen. Knives and other hazardous items were locked and inaccessible to residents in care. Medications are locked in kitchen cabinet where it is inaccessible to residents in care. Cleaning products and other toxins are located in the locked laundry room and inaccessible to residents in care. There was a supply of linens, cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents were supplied with paper towels and hand soap, and outfitted with grab bars and non-slip floors/mats. A tour of all resident bedrooms was conducted, and bedrooms inspected have lighting and appropriate furnishing. (Report continued on LIC 809C) Continued from 809........ LPA discussed the Emergency Disaster Plan in detail. Licensee has a backup generator and a supply of water and non-perishables. Component III was waived due to Licensee already being licensed. LPA found no deficiencies at the facility at the time of inspection. Exit interview was conducted, and a copy of this report was given to the Licensee. LPA will forward this report to the Licensing Program Manager and assigned Application Analyst in our Department.