Facility Evaluation Report

Licensing Program Analyst (LPA) Bethany Mirlohi arrived to conduct a pre-licensing inspection. LPA met with Licensee/Administrator Julie Malitskiy during today's inspection.

Facility was inspected both indoors and outdoors. LPA inspected 6 resident bedrooms, 2 bathrooms, 1 staff room, common living areas, kitchen, garage, and outdoor areas. Outdoor area is free from hazardous debris. Outdoor exits are clear and accessible. First aid kit was present in the facility. Centrally stored medications will be stored in locked cabinet in the kitchen area. LPA inspected resident bedrooms and the bedroom had appropriate furnishings, adequate lighting and storage. Bathrooms are clean, sanitary, and in good repair. Grab bars and non-skid mat was present in all bathrooms. Smoke detectors and carbon monoxide detectors were checked. Fire clearance was granted on 01/24/24 for 6 non-ambulatory residents. Kitchen is clean, sanitary, and in good repair. A working telephone has be set up for residents use.

Licensee agrees to notify LPA once first consumer is admitted. This report will be forwarded to the centralized application unit for continued processing. Comp III was waived.

Exit interview conducted and copy of report provided.