Pre-licensing visit·October 17, 2025

On 10/17/2025 , Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a pre-licensing inspection. LPA met with Administrator, Irene Monteclar and explained the purpose of the visit. The facility currently has four (4) residents. The administrator currently holds a certificate (#7033135740) that expires on 6/25/2026. The facility’s fire clearance was approved for four (4) total capacity, all may be non ambulatory. LPA toured facility with Administrator Irene Monteclar including but not limited to bedrooms, bathrooms, kitchen, common area, garage, and back yard. The facility consists of five (5) rooms, which (4) are occupied by the residents and one (1) is occupied for an office space for staff. The facility has three (3) bathrooms. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 71 degrees F and hot water temperature was maintained at 114.1 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 7/3/2025. LPA reviewed four (4) resident records and four (4) staff records. LPA reviewed a sample of medication. Continued on LIC809-C. Continued from LIC809. The following forms to be updated and submitted to CCLD by 10/24/2025 : Liability Insurance (reviewed) LIC 308 Designation of facility's Responsibility LIC 500 Personnel Report No issues noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted and a copy of this report provided.