Pre-licensing visit·August 1, 2025

Licensing Program Analyst (LPA) Evelin Rios conducted an announced Pre-Licensing Inspection with the applicant representative and Administrator Celia Oyibu. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 04/10/2025. A fire clearance was approved on 05/21/2025 for six (06) ambulatory residents for a total capacity of six (06). A tour of the physical plant was initiated at approximately 9:30 a.m., and the following was observed: At entrance LPA observed a fire extinguisher fully charged with purchase date 04/2025. KITCHEN: The kitchen is equipped with a refrigerator, microwave, stove, two ovens and dishwasher. There is a sufficient supply of seven day non-perishable food items, properly stored. Applicant has a sufficient amount of tableware, dishes and utensils to accommodate the capacity of the facility. Knives and sharps were observed locked in a cabinet in the kitchen. Centrally stored medication, medication records will be locked in kitchen cabinet. COMMON AREAS: The common areas include the living room and dining area. The common areas are furnished with couches and televisions. There are two (02) fireplaces, one (01) is blocked by a couch and the other is properly secured with a screen. The dining room table is large enough to sit the capacity of the facility. Floors and furniture were observed to be in good repair. First aid kit is accessible in the dining area. Facility will keep staff and residents records looked in a filling cabinet in the living room. (Continue to LIC809-C) BATHROOMS: The facility has two (02) bathrooms. One (01) bathroom is located in the staff bedroom. The resident bathroom was observed to have the proper fixtures, grab bars, and non-skid mat. The hot water temperature was measured and was within regulation. BEDROOMS: There are three (03) bedrooms that may be shared. Bedroom #3 is currently furnished for private use. The applicant furnished the resident bedrooms with beds, night stand, chairs, chest of drawers, and bedding. The bedrooms have sufficient lighting and closet space. Facility windows and screens were observed in good repair. GARAGE/LAUNDRY: The garage is attached to the house and the door to the garage will be maintained locked. The cleaning supplies, chemicals and detergents are locked in the garage. The washer and dryer are located in the garage. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alarms. The backyard is fenced in and has a shaded patio and appropriate backyard furniture. The facility's backyard has sufficient space for outdoor activities. There is a pool with a gate and two gate doors locked with padlocks inaccessible to residents. The smoke detectors are dual carbon and smoke, they are hard wired and inter-connected. LPA observed the administrator test one smoke detector that set off all smoke detectors through out the facility. The applicant representative/ administrator completed component III. Pre-Licensing is complete and this facility has no deficiencies. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the license has been approved. Exit interview was conducted. A copy of this report was signed and provided.