At 1:10 p.m., the LPA toured the physical plant areas inside and outside with the applicant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: Kitchen knives are stored locked and inaccessible in a drawer on the left hand side of the stove. The supply of perishable and nonperishable food is adequate. The supply of dishes is adequate. Appliances in the kitchen were clean and appeared functional. There is an adequate supply of emergency food. The facility recently completed a full home remodel, in which appliances and cabinets were replaced.

BEDROOMS: There are (7) seven bedrooms in the facility; the facility has (6) six private bedrooms for resident use, and (1) one staff room. The staff room is kept locked. Room #3, #5 and #7 have direct access to the outside. Lighting in the rooms appeared adequate. (6) six out of (6) six private resident rooms and (1) staff room were set up with beds, night stands, lamps, chests of drawers, chairs and closet space.

BATHROOMS: There are (6) six full bathrooms. There are five (5) private bathrooms for resident use; the full bathroom near the entrance of the home next to the kitchen is designated for staff and guests. The showers are equipped with nonskid surfaces and available nonskid mats. Grab bars were observed in the bathrooms. Hot water temperature in bathrooms measured between 110.4 – 119.8 degrees Fahrenheit.

Continued on LIC 809-C.

Emergency exiting plans/sketch are posted. Emergency telephone numbers are posted in the dining area wall. Other required postings are also posted on the dining area wall.

MEDICATIONS: Medications are in a locked cabinet in the kitchen to the right of the dishwasher. The first aid supplies were complete, including a first aid manual. They were stored in the medication cabinet.

FILES: Resident and staff records are stored in a filing cabinet which is currently located in the hallway next to room #5.

LAUNDRY: The laundry area is in the kitchen area, directly across from the designated staff room. Laundry detergent and chemicals are stored inaccessible under the kitchen sink.

EXTERIOR: The exterior passageways were clean and clear of any obstructions. There is a covered patio area in the backyard with tables and chairs for resident use. There are no bodies of water noted on the premises. The back and sides of the house are separated from the front yard by gates at the north and south side passageways, both gates have self-latching mechanisms. There is no front yard gate or driveway gate. The garage on the property has been converted into a residential unit with a separate address which in not attached to the house. There are no other structures on the property.

INFECTION CONTROL: The facility has a central entry point for symptom screening and sanitation station for staff, residents, and visitors. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19.

Facility is in compliance with Title 22 Regulations at this time. This report will be sent to the Centralized Application Bureau (CAB). The CAB Analyst will notify the applicant when the license has been approved. The applicant is aware that they are unable to operate under the new license number until they have been notified that the license has been approved by the CAB Analyst. Failure to comply could affect approval of the license. Exit interview conducted and report issued.