Facility has a fire clearance for 3 ambulatory clients and 1 non-ambulatory clients. Administrator certificate # is 6027063735, which will expired on 06/18/2023. Administrator has already submitted all documents required for administrator recertification. Administrator has already submitted all documents required for administrator recertification. LPA Lee inspected the interior and the exterior of the facility including the common living spaces, client bedrooms, bathrooms, and the kitchen. Client bedrooms were furnished, and client bathrooms were in good repair. LPA Lee observed required furniture and lighting throughout the facility. The first aid kit was checked and is complete. LPA Lee observed the centrally stored medication areas to be locked and made inaccessible to the clients at this time. The facility smoke detectors, carbon detectors, and fire extinguishers are in good repair. The facility has an adequate of utensils, seven day non-perishable and two day perishable food supplies. The water temperature measured at 118.2 degrees Fahrenheit, and the facility temperature was 72 degrees Fahrenheit. LPA Lee observed staff and resident files to be locked and readily available for review. LPA Lee reviewed 4 out of 4 client files and they are complete. LPA Lee also reviewed 3 out of 6 staff files and they are complete. The facility has an infection control plan completed and provided to Licensing for approval.

The applicant has passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. The Applicant is the Licensee of another licensed care facility. The Applicant has previously completed component III, as a result LPA Lee waived the Component III for this facility. An exit interview was conducted, and a copy of this report was provided to the Applicant.