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25 | Licensing Program Analyst (LPA) Kelly Dulek conducted a pre-licensing inspection for this proposed facility. LPA arrived at 09:43AM and met with Licensee Representatives Janette Villapando, Bernadette Abiera, and Michelle Racan. Entrance interview conducted.
Fire clearance was approved on 01/18/2024 for 6 (six) total residents, all of which may be non-ambulatory. The facility has an approved hospice waiver for 6 (six) and a pending dementia care plan. A tour of the facility was initiated at 09:54AM with the licensee representatives. LPA inspected facility for Fire Safety, Personal Accommodations and Services, Medication Procedures, and Food Service. The following was noted:
Fire extinguishers were purchased on 12/01/2023. Hardwired combination smoke/carbon monoxide detectors, as well as fire door were tested during today’s visit at 10:03AM and were functional at the time of the visit. LPA observed all required postings on the wall in the main hallway/entryway.
Bedrooms: There are 5 (five) total bedrooms in the facility; 4 (four) are designated for private resident use and 1 (one) is a shared room. All resident bedrooms were inspected and contained appropriate furnishings and linens. The facility also contains a staff room, which was observed to be locked.
Bathrooms: The facility contains 3 (three) full bathrooms; 1 (one) is located in the hallway and is designated for shared use, 1 (one) is a private resident restroom, and 1 (one) is designated for staff and resident use. LPA observed all 3 (three) bathrooms were clean, properly supplied and had functional fixtures. LPA observed all bathrooms to have non-skid mats and grab bars. Hot water was measured in 2 (two) of the 3 (three) bathrooms and measured within the required range.
Kitchen: The kitchen appeared clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of non-perishable food at the facility; properly stored. Cleaning supplies are Report Continued on LIC 809-C
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