Facility Evaluation Report

On 4/5/2023 LPA Tryon visited the facility to conduct a prelicensing visit. LPA met with applicant Che Chiang Chang. The facility is currently licensed by the previous owner, and there are 5 residents in care.

LPA reviewed the CARE Tool for prelicensing with the applicant.

LPA toured the facility with applicant and current licensee. LPA viewed common areas, kitchen, dining room, bedrooms, bathrooms, laundry room, storage, garage, patio/yard.

Smoke detectors present and functioning. Carbon monoxide detectors installed. Fire extinguisher present and charged/checked recently.

The facility is in good condition and clean. All floors, ceilings/walls, doors, etc in good condition. The house is nicely furnished. Appropriate furniture present.

Food supplies are adequate to meet the requirement of 2 days perishable/7 days non-perishable.

Appropriate first aid supplies available, as well as emergency lighting.

Facility has appropriate forms for staff and resident files.

LPA reviewed the RCFE Orientation Component III with applicant. At this time, the applicant has completed the RCFE Orientation Component III.

At this time, the facility appears to be in substantial compliance with the regulations.