Pre-licensing visit·August 20, 2025

On 08/20/2025 at 1:00PM Licensing Program Analyst (LPA) T. Syess-Gibson conducted an announced pre-licensing inspection. LPA met with Sara Bughio, Administrator and Ali Soomro, Licensee. The facility has a fire clearance for six (6) non-ambulatory and a hospice waiver for three (3) residents. LPA inspected the facility inside and out including but not limited to the bedrooms, bathrooms, common living areas, kitchen, garage and back yard. The facility has a total of six (6) bedrooms, two and half (2 1/2) bathrooms. There were no bodies of water present during inspection. There is sufficient lighting around the facility. Residents’ rooms are equipped with the proper furniture, bedding, and lighting. Bathroom showers/tubs were equipped with grab bars. Passageways and hallways are free of obstruction. LPA observed locked cabinets available to store medications, sharps and toxins. Hot water temperature is measured at 114.1 degrees Fahrenheit. Fire extinguisher was last purchased on 03/08/2025. Carbon monoxide and smoke detectors are present. First-Aid kit was observed complete. Facility inspection matches the sketch that was provided. LPA observed facility had some non-perishable food supply. Licensee will purchase additional food supplies once facility is licensed. Continue on LIC809 Continued from LIC809 The licensee/administrator was reminded of the statute that requires CCL to be notified within 5 business days of admitting their first resident. This notification may be made by phone, by mail, email, or by fax. No issues were 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. LPA Conducted COMP III on 08/20/2025. Exit interview conducted and a copy of this report provided.