A file review was conducted prior to the visit. The facility is a single story building with five (05) bedrooms, two (02) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for three (03) nonambulatory residents and one (01) bedridden resident in Bedroom #5.

LPA and the Applicant reviewed Component III at approximately 1:15 p.m.

At the main entrance, LPA observed postings for the administrator certificate, emergency disaster plan with emergency contacts, visitation policy, personal rights, and confidential complaint contacts. Walls, floors, windows, screens, and curtains were clean and in good repair. At 2:00 p.m. LPA measured the room temperature to be 74.0 degrees Fahrenheit. A linen closet in the hallway contained adequate supplies of fresh linens and hygiene supplies. The living room contained furniture in good repair, a television, and an appropriately covered fireplace. The shaded patio area in the rear of the facility contained adequate space and was free of debris. Ramps leading to and from the living room and Bedroom #5 were secure. A shed near the patio was unlocked and contained assistive devices. At approximately 2:15 p.m., the smoke and carbon monoxide detectors were tested and operational. Detectors were hard-wired and functioned simultaneously when tested.

The facility has five (05) bedrooms. Bedroom #1 is in the rear of the facility and is designated for staff. All client bedrooms contained a chair, lamp, nightstand, storage, emergency lighting, and a bed with adequate bedding. All furnishings were clean, new, and in good condition.

LPA observed an adequate supply of perishable and non-perishable foods in the refrigerator, freezer, and pantry. The kitchen also contained supplies of emergency food and water. The stove hood was clean. Appliances were in good condition. An activity calendar was posted in the dining room. A weekly menu was posted in the kitchen. Sharps were locked above the counter. Cleaning solutions were locked below the sink. Medications were locked in a file cabinet in the dining area.

A washing machine and dryer were located in the laundry area near the kitchen. Both were in working order. Detergents were locked below the counter.

All emergency exit paths were free from obstructions. Three (03) out of three (03) exit gates were unlocked. The southern wall of the home’s exterior and the southern fence require light repairs but do not pose health or safety concerns to clients. At approximately 2:50 p.m. LPA observed a fully charged fire extinguisher in the kitchen. It was purchased on 05/24/24. At 2:55 p.m., the house telephone was tested and deemed operational. At 3:10 p.m. LPA observed a fully-stocked first aid kit in the kitchen.

During today’s inspection, no immediate health or safety hazards were observed.

Pre-Licensing is complete and this facility has no deficiencies.

Exit interview conducted. Copy of report provided.