Pre-licensing visit·February 10, 2026

Licensing Program Analyst (LPA) Quoc Huynh conducted a pre-licensing visit to the above noted facility. At 12:56PM, the LPA met with Applicant Vincetta Mendola. Entrance interview conducted. An application to operate a Residential Facility for the Elderly was submitted on 06/02/2025. A dementia program was not included in the plan of operation and the facility does not plan to retain residents diagnosed with dementia. A Hospice Waiver was not submitted at this time. The facility's fire clearance was approved on 01/12/2026 for a total of six (6) ambulatory. Component II orientation was completed on 01/20/2026. Component III was completed with the applicant during today's visit. Beginning at 12:58PM, a physical plant tour was conducted. The following was observed: KITCHEN: Knives and cleaning supplies were stored in a locked cabinet. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at 0*F and the refrigerator was maintained at 40*F. The supply of nonperishable foods and emergency food supply is adequate. There are no pesticides or toxins stored in any food storage area or preparation area. Appliances in the kitchen were clean and functional. At this time centrally stored medications did not have a secure location. First aid kit was observed to be complete, including a thermometer and a current version of a first aid manual. Report Continued on LIC 809-C BEDROOMS/BATHROOMS: The facility had three (3) bedrooms. Bedroom #3 had a direct access to the outside. Resident rooms were set up with beds, nightstands, lamps, chairs, sufficient clothing storage and closet space. The beds were furnished with box springs, comfortable mattress and clean linen, which includes, a mattress pad, top and bottom linens, pillowcases, and blanket (if needed). Bedroom #2 did not have a bed set up. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. In addition, no bedroom was used as a passageway to another room, bath or toilet. All rooms were free of odors. All window screens were clean and maintained in good repair. There were three (3) bathrooms: two (2) private and one (1) shared. The bathrooms have a shower in need of non-slip mats. The toilet and shower needed grab bars installed. The hot water temperature was tested and measured within the required range of 105*F to 120*F. COMMON AREAS: The living room was appropriately furnished, and the lighting was adequate. There was a television, and/or activity supplies in the living room. Dining room furniture was not observed at the time of the visit. There was sufficient space to accommodate both indoor and outdoor activities. The physical plant is consistent with the submitted facility sketch/floor plan. The facility had emergency lighting, which included but not limited to flashlights. Nightlights were observed throughout the common areas. The facility has central heating and air conditioning to maintain rooms to a comfortable temperature. At 3:32PM, the hardwired smoke and carbon monoxide detectors were tested and functioned properly. The fire extinguisher throughout the facility were fully charged and purchased on 12/12/2025. A supply of extra bed linens were not observed. There is a washer and dryer closet located in the hallway and observed to be in good condition. There is a functioning telephone on the premises. All required postings are posted near the entrance and kitchen of the facility. Report Continued on LIC 809-C OUTDOOR AREA: The exterior passageways were clean and clear of any obstructions. Bedroom #3 had a private rear yard. The front yard had furniture in good condition. The front yard also had a driveway with a remote operated gate and door for everyday use and in the event of an emergency. There were no bodies of water on the premises at the present time. The facility is on a property with an Additional Dwelling Unit (ADU) owned by the same owner and occupied by parties unrelated to the facility. The ADU also has its own secured perimeter and will remain inaccessible to residents. The following corrections are needed prior to licensure: - Obtain a dining table with sufficient number of chairs for residents - A designated and secure location for centrally stored medications - Grab bars installed for each toilet and shower in addition to non-slip mats - Bedroom #2 needs the bed set up - Purchase extra supply of bed linens including bed sheets, blankets, and pillowcases The Applicant is to notify the LPA once corrections have been made, but no longer than 02/24/2026. Exit interview conducted. A copy of the report was reviewed and issued.