Pre-licensing visit·July 18, 2025

On 7/18/2025 at 2:15pm, Licensing Program Analyst (LPA) L. Hall conducted an announced pre-licensing inspection. LPA met with Liwayway Mendoza, Administrator/Licensee, and Dennis Mendoza, Licensee, and explained the purpose of the visit. The facility has an approved fire safety clearance for six (6) non-ambulatory residents. Approved hospice waiver for two (2). LPA inspected the facility inside and out including but not limited to the bedrooms, bathrooms, common living areas, kitchen, garage, back yard. The facility has a five (5) bedrooms and three (3) bathrooms. No bodies of water observed. There is sufficient lighting around the facility. Bathrooms showers/tubs were equipped with non-skid mats. Passageways and hallways are free of obstruction. Locked cabinets available to store medications, toxins and sharps. Hot water temperature is measured at 113.2 degrees Fahrenheit in shared residents' bathroom. Fire extinguisher was serviced on 6/10/2025. First Aid kit was complete. Carbon monoxide and smoke detectors present. Facility inspection matches the sketch that was provided. This is a relocation pre licensing inspection. *Comp III waiver approved by Licensing Program Manager H. Humpal* Continued on LIC809C. Continued from LIC809. 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. Exit interview conducted and a copy of this report provided.