Facility Evaluation Report

Announced Pre-licensing visit made via to this facility on 10/15/2021, LPA Anthony Tuck was met by the Applicant,Roxanne Omoaholo, who was briefly interviewed by LPA.

It was learned that this facility will be licensed to serve up to (4) residents (all) ambulatory at any given time.

There were no residents in care during today's Pre-licensing visit.

Tour of the facility was conducted with applicant. Dining area, living area, and all other areas intended for resident use were toured and observed to be furnished and maintained in compliance at this time.

Kitchen area was toured. Cabinets and drawers were opened and reviewed by LPA Tuck along with the Applicant. Knives and other sharp utensils were observed to be locked in a cabinet to make them inaccessible to the residents at all times.

Food supply for 2-day perishable and 7-day nonperishable quantities were reviewed to make sure that this facility was in compliance at this time.

Medication cabinet, located in the hallway area, was toured. First aid kit was observed to be present and contained all required components at this time.

A tour of the (2) private resident bedrooms and 1 shared resident room was conducted.

Furnishings and furniture intended for use by the residents were observed to be sufficient and able to meet the needs of the residents at this time.

A tour of the resident bathrooms was conducted. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Nonskid mats were observed to be present and in compliance at this time.

Laundry area was toured. All cleaning agents and detergents were observed to be locked and made inaccessible at this time. Continued on LIC 809C...