Facility Evaluation Report

On 05/09/2025 at 9:00 am, Licensing Program Analyst (LPA) Noel Wolf Petersen and Licensing Program Manager(LPM) Liza King arrived announced to perform a follow up pre licensing inspection, and met with administrator/licensee Ebony Aliriagwu and explained the purpose of the visit. Admin cert expires 03/17/2026.

Facility is licensed to provide housing to dementia residents 2 ambulatory and 4 nonambulatory in 3 shared rooms. LPA inspected the Physical Plant, including but not limited to the common areas, resident bedrooms and resident bathrooms. Prior concerns with incomplete preparedness including but not limited to: the storage of the fire extinguishers being locked and inaccessible, the posters not being up , the rubber mats not being in the showers, the bathroom trashcans with lids missing, the nightlights in the halls/bathrooms missing. Grab bars for the shower, the walkways to the emergency exit were obstructed in the master bedroom and the cameras had microphones (in the kitchen area and along the side of the house and backyard) were reviewed and observed to be addressed and now complaint. Master bathroom toilet continues to need grab bars, licensee will address this and send pictures to LPA. The facility has cameras in the common area, signs have been posted and the admissions agreement contains an addendum to notify residents of this.Technical Assistance provided re elopement behaviors and the requirements for awake staff and auditory signal system on the doors.

During todays visit, LPA reviewed the facility admissions agreement, resident and staff mock files, emergency preparedness documentation and discussed various scenarios with licensee. Comp III was reviewed with the licensee. LPA will notify CAB that the facility has passed the prelicensing inspection. Licensee will be notified by CAB of licensure. Licensee is to notify LPA upon accepting first resident into care. Report reviewed with Licensee.