Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an announced pre-licensing inspection. This is a change of ownership. Applicant is applying for Residential Care for Elderly to serve residents for age 60 and above. The facility was previously licensed to St Elizabeth’s Home for the Elderly with facility# 198603540. The current applicant’s licensee is St. Sebastian Home of the Elderly, LLC. LPA met with Briana McGee, applicant/ administrator. The requested capacity is six (6). Facility has an approved Dementia Care Plan . Hospice waiver was approved for six (6). Administrator certificate is current with expiration date on 11/19/23.

Fire clearance was granted on 03/20/23 for six (6) non-ambulatory and zero (0) bedridden. Fire clearance and Dementia care plan are in place. Auditory device is installed at all exits and operable.

The property is a single-family residence located in a neighborhood, consisting of four (4) bedrooms approved for non-ambulatory residents, two (2) bathrooms, kitchen, dining area, laundry area, and living room with a TV. Passageways, walkways and patios are free from obstructions. The entrance and side areas are free of hazards and debris.

Facility does not have a signal system. Garage is not accessible to residents.