Pre-licensing visit·March 3, 2026

Licensing Program Analyst (LPA) Quoc Huynh conducted an announced pre-licensing visit to the above noted facility. At 9:49AM, the LPA met with Applicants Alvin Uy and Suresh Jayakar. Entrance interview conducted. An application to operate a Residential Facility for the Elderly was submitted on 07/14/2025. A dementia program was included in the plan of operation. A Hospice Waiver for six (6) has been requested. The facility's fire clearance was approved on 09/02/2025 for six (6) bedridden, with a total capacity of six (6) residents. Component II orientation was completed on 02/04/2026. Component III was completed with the Applicants during today's visit. Beginning at 9:53AM, a physical plant tour was conducted. The following was observed: KITCHEN: Knives were stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans and drinkware was adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable foods and emergency food supply was adequate. Cleaning supplies will be stored in a locked cabinet under the kitchen sink. There were no pesticides or toxins stored in any food storage area or preparation area. Appliances in the kitchen were clean and all appeared functional. Report Continued on LIC 809-C BEDROOMS/BATHROOMS: The facility had seven (7) bedrooms: six (6) private resident rooms and one (1) staff room. Bedrooms #1 through #6 had direct exits 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). 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 eight (8) bathrooms: six (6) private resident bathrooms, one (1) staff, and one (1) visitor bathroom. The bathrooms had a shower with non-slip mats. The toilet and shower have grab bars. The hot water temperature was tested and measured within the required range of 105*F to 120*F. COMMON AREAS: Common areas were appropriately furnished, and the lighting was adequate. There was a television, reading materials, and/or activity supplies. There was sufficient space to accommodate both indoor and outdoor activities. Alarms on all exterior doors were engaged at the time of visit and functional. In addition, 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 had emergency food and water available. The facility has central heating and air conditioning to maintain rooms to a comfortable temperature. At 1:11PM, the hardwired combination smoke and carbon monoxide detectors were tested and functioned properly. The fire extinguishers throughout the facility were fully charged and purchased on 09/11/2025. The supply of extra bed and bath linens as well as personal hygiene items were adequate in the hallway closet. There was a functioning telephone on the premises. All required postings were posted near the entrance of the facility. First aid kit was observed to be complete, including a thermometer and a current version of a first aid manual. Medications and files will be locked in a hallway cabinet in addition to extra linens. Report Continued on LIC 809-C OUTDOOR AREA: The exterior passageways were clean and clear of any obstructions. There was an enclosed courtyard in the center of the property. Furniture in good condition with shade were observed. The outdoor space was property gated and a shed was observed in the rear for general storage. There were no bodies of water on the premises at the present time. There was one (1) emergency side exit that led to the front yard. The premises had a locked garage that was used as facility storage. No corrections required. Exit interview conducted. A copy of the report was reviewed and provided. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect the approval of your license.