Facility Evaluation Report

On 12/20/2023 at 12:45PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct Pre-licensing Inspection. Upon arrival, LPA met with Berries Jean Administrator, and explained the purpose of the visit. The facility currently has no residents.

LPA toured facility including but not limited to 3 bedrooms, 3 bathrooms, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and shower seat. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 66 degrees F and hot water temperature was maintained at 111 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was purchase on 09/28/2023.

No issues noted during inspection. LPAs observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided via email.