Facility Evaluation Report

On 09/08/22 at 1:40PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct a Change of Ownership Pre-licensing Required inspection. LPA met with Applicant/Administrator and explained the purpose of the visit. The facility currently has 2 clients. LPA observed one staff wearing face mask during visit. Routine COVID symptom checks was done by staff at the front entrance. Screening station had visitors log, no touch temperature probe, additional masks and hand sanitizers.

LPA toured facility with applicant including but not limited to 4 bedrooms, 3 bathrooms, kitchen, common areas and backyard. COVID signages were observed in the kitchen, bathrooms and common hallways. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with covered trash bins and paper towels on holders. Linens and hygiene supplies were observed inside a cabinet. Medications and toxic chemicals were observed locked in the garage and cabinets. There is sufficient lighting throughout facility. Room temperature was maintained at 77 degrees F and hot water temperature was maintained at 119 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 03/21/22. Pathways inside and outside were observed free of fire hazards.

This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is subject to final approval by CAU. Additional requirements may still be required.

No deficiencies observed during visit. Exit interview conducted and a copy of this report provided.