Facility Evaluation Report

On this day at around 11:45 AM, Licensing Program Analysts (LPA) Luisa. Fontanilla arrived announced to conduct pre licensing inspection. LPA met with staff Donna Caceres and explained the purpose of the visit. The Licensee/Applicant Administrator Thinn Aye arrived to the facility at around 12:10 PM. This pre-licensing request is for change of ownership (CHOW).

LPA inspected the facility including but not limited to 7 bedrooms 2 of which are used as staff rooms, 3 bathrooms, kitchen, common areas and backyard. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 68 degrees Fahrenheit. Hot water temperature measured at 131.1 degrees Fahrenheit. First aid kit was observed to be complete. Smoke detectors and carbon monoxide were tested and observed functional. Fire extinguishers were last serviced on 11/2024.

LPA reviewed 5 resident files and 4 staff files.

The following deficiencies were observed:

One resident is diabetic and on insulin but unable to manage

Insulin was observed unlocked in the refrigerator

The facility is not yet licensed. Pre licensing has not been completed until deficiencies are resolved.

Exit interview was conducted and a copy of this report was provided to Licensee/applicant.