Facility Evaluation Report

Licensing Program Analyst (LPA) Michelle Reed conducted an announced Pre-Licensing visit. Upon arrival, LPA met with Dee Apostu (Administrator appointed by applicant), Program Manager Anne Connor and Compliance Manager Crystal Goodwin. Covid signage as well as precautions were in place. LPA's temperature was taken. The initial application to operate a Social Rehab Facility was submitted to the Central Applications Bureau (CAB) on 8/17/21 for a capacity of 6 ambulatory residents. A tour of the physical plant was conducted and the following was observed:

Structure: Facility is a two story building with 9 rooms. 4 of the rooms will be resident rooms. They are located downstairs and will be Bedroom #1, #2, #3 and #4. There are 4 bathrooms for resident use. The other rooms will be used as offices. There is also a swimming pool that meets Title 22 regulation and a tennis court, gym and art room and a group recreation room. Shaded patio seating is available. The garage is for storage and car parking only.

Bedrooms Residents: At this time there is no fire clearance for bedridden residents. The applicant will have 24-hr staffing and there is no staff room. Emergency lighting was present throughout the facility. Resident bedrooms accommodate residents' furnishings. Nightstands, lights, closet space and dressers were present with appropriate beds and bedding.

The water temperature was observed to be 106 degrees F which meets regulation guidelines.

Medications, First Aid Kit & Manual: First Aid kit and manual were present in the facility. Medication will be stored in a locked medication room.