Pre-licensing visit·January 12, 2026

Licensing Program Analyst (LPA) Jill Clancy-Czuleger, conducted an announced pre-licensing inspection. License application is for (6) total capacity, of which 5 maybe non-ambulatory and 1 maybe Bedridden. Fire clearance was granted on October 10,2025. LPAs met with Mary Ann Gamido (applicant-licensee). LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPAs inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. Fire extinguishers were observed fully charge. The two-in-one carbon monoxide and smoke detector tested and observed functional. First aid kit checked. Hot water temperature in one of the bathrooms tested and measured at 119.8 degrees Fahrenheit. Continued on LIC 809C... LPAs observed the following: Window screens missing in all bedrooms The facility does not have a phone The facility needs railing for ramps The facility needs a full first aid manual The facility needs an emergency power source Upon receipt of the proof of corrections for the 5 items above, LPA J. Clancy-Czuleger will inform CAB. Issuance of license is pending upon final review by CAB analyst. Exit interview conducted and copy of this report provided.