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25 | Licensing Program Analysts (LPAs) Lizzette Tellez and Elizabeth Hamilton conducted a Pre-Licensing Tele-Virtual Visit due to COVID-19. LPAs identified themselves to the Applicant's Administrator, Shawn Amirhoushmand, and we discussed the purpose of the visit. The facility will serve 92 non-ambulatory elderly residents, eight (8) of whom may be bedridden. A hospice waiver has been approved for eight (8) residents.
LPAs conducted a virtual tour of the facility, both inside and outside. Smoke and carbon monoxide alarms were present throughout the facility. Per Mr. Amirhoushmand, there are no firearms stored on the premises. The facility was observed to be clean and in good repair. Bathrooms intended for resident use were clean and in good repair. Resident rooms were observed with the appropriate furniture, bedding and appropriate lighting. Hot water temperature was measured in the facility at 110.5 degrees F. The refrigerator and freezer were observed to be clean and operational. Cleaning solutions were also properly secured. There is sufficient activities space throughout the facility. There is a locked medication room. Personnel and resident records are store in locked office rooms on the premises. The facility has delayed egress devices on the second floor, which were observed to be operational, but were not noted as approved on the fire inspection request.
The Component III portion of the application process was completed with Mr. Amirhoushmand. An updated fire clearance is required prior to the facility's licensure. Upon receipt, this application will be sent to the Centralized Applications Bureau (CAB) for final review and approval. The Applicant will then be notified of management approval by phone and the new license will be mailed to the Applicant.
An exit interview was conducted with Mr. Amirhoushmand. A copy of this report along with Applicant Rights (LIC9058 01/16) was provided to him via email with an electronic read receipt. |