Pre-licensing visit·March 18, 2025

On 03/18/2025 at 10:45AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived announced to conduct a pre licensing visit. LPA met with Licensee, Wais Naderi/Administrator, Joy Bisaha and explained the purpose of the visit. The facility currently has no residents. The facility’s fire clearance was approved for four (4) non-ambulatory and six (6) bedridden resident. LPA toured facility with Licensee, Wais Naderi/Administrator, Joy Bisaha including but not limited to six (6) bedrooms, three (3) bathrooms, kitchen and common areas. 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 105.7 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last purchased on 04/26/024. Continue on LIC809C Continued from LIC809 The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB): 1.) LPA observed facility doesn't have an accurate fire clearance STD850 identifying bedridden rooms. 2.) LPA observed facility doesn’t have telephone service. 3.) LPA observed facility doesn’t have an outdoor activity area that is easily accessible to the residents, protected from traffic, and have adequate shady areas. 4.) LPA observed facility doesn't have a dementia care plan that address behaviors such as ingestion of toxic chemicals and wandering behaviors. Licensee/Applicant will submit proof of corrections to CCLD on or before 03/25/2025 LPA will conduct face-to-face comp III presentation on next visit. Exit interview conducted and a copy of this report provided.