Pre-licensing visit·April 28, 2026

On this day, April 28, 2026, at 10:40 am, Licensing Program Analyst (LPA) Delmundo conducted an announced pre-licensing re-inspection, and met with Haidar Hadi, applicant. License application was changed from four (4) total capacity to five (5), all non-ambulatory. Fire clearance was granted on October 25, 2025. Application is an initial/new application for license for this location. LPA toured the facility inside out. There is no body of water. LPA inspected the living room, dining area, kitchen, bedrooms, bathrooms, front, side and backyard. LPA observed the following: -there's no longer renter. -kitchen counter and cabinets were replaced/upgraded and flooring was also upgraded. -all bedrooms were appropriately furnished with beds with covers, comforters, bed sheet and mattress pads, drawers, night stand, lamps and overhead lighting. Living and dining room furnished. -bathrooms were observed clean. -fire extinguisher securely hanged and flashlights for emergency use are available. -ground surface for activity area in the side yard leveled and roof installed. -closet for central storage for medications with lock. -facility is equipped with microwave, refrigerator, kitchen and cooking utensils, and hygiene supplies for residents use were available. ....continued on 809C CONTINUATION FROM PAGE 1: LPA also observed the following that need to be corrected: -fireplace not secured. -range knob with no covers -cleaning supplies in the cabinet underneath the sink with no lock. -kitchen drawer for sharps without lock. -dusty kitchen range hood and cob webs on the front porch ceiling. -no grab bars on shower and toilet areas. -no call buttons for residents use. -shovel, pails of paint, bricks, metal pipes in the side yard. -no paper towel holder/dispenser in the bathrooms. -no patio furniture in the activity area in the side yard. Applicant stated he will submit the proof of corrections (POCs) by May 12, 2026: -stated he'll have the fireplace replaced and secured. -purchase covers for the range knobs. -install locks on the kitchen cabinets for the cleaning supplies and sharps. -have the range hood and porch ceiling cleaned. -install grab bars and paper towel holders in the bathrooms. -purchase call buttons. -lock the shovel an clean the side yard. -install paper towel dispenser in the bathrooms. -purchase patio furniture. Applicant to post the following in the prominent place and submit pictures: Ombudsman and Complaint posters; Rights to Resident Council; Rights to Family Council; Theft and Loss Policy; Personal Rights Upon receipt of POCs, LPA will inform the Centralized Applications Bureau analyst who will approve and grant the license. Exit interview conducted and copy of this report provided.