Pre-licensing visit·September 15, 2025

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at this facility for the purpose of conducting a Pre-Licensing Inspection. LPA met with Braulio Paulino-Pena, CEO and completed this inspection. All required postings were visible off kitchen hall. LPA began with a tour of the 3 client bedrooms and 2 bathroom home. The medication will be stored in the front entryway closet that is kept locked. There is a step down into a sunken living room with seating for all residents. The kitchen area has a table with seating for all residents. All kitchen surfaces are clean and intact and suitable for preparing meals. Appropriate kitchen appliances were observed all in working order. Dishes and utensils were observed. Extra linens and bedding were observed in a hallway closet. Each bedroom has an appropriate bed and furnishings. Garage is off of the kitchen area and is kept locked at all times. Extra refrigerator and freezer are kept in the garage. Locked cabinet with chemicals and cleaning supplies are stored here. Backyard has a large grass area with a picnic table and a glass table with four chairs. There is a shady area for residents to gather and sit. Gate on south side of building can be easily opened and closed and is not locked. Fire extinguishers were observed and have a service date of 06/19/2025. Water temperature was at 117.3 degrees F. Smoke alarms and carbon monoxide detectors were tested and in working order. Emergency Disaster and Infection Control Plans were reviewed and COMP III was conducted during this visit with CEO. (Continued on next page) Pre-Licensing is incomplete with deficiencies to be resolved by 9/19/2025. A follow up Pre-Licensure LIC809 will be generated upon resolution of deficiencies. An exit interview was conducted and a copy of this report was left with CEO, whose signature confirms receipt.