Pre-licensing visit·September 29, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with facility Administrator Alya Iwas Askar . An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on April 21, 2025. A fire clearance was approved on July 09, 2025 for a maximum capacity of five (5) non-ambulatory adults and one(1) bedridden. Hospice waiver has been requested for six (6) residents which is pending approval of Manager. A tour of the physical plant was initiated at 9:40 am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. BEDROOMS: There are three (3) bedrooms designated for residents use. All three bedrooms will be designated for shared rooms. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space. Bedroom#1 is cleared one(1) bedridden. BATHROOMS: The facility has one (1) main bathroom and one (1) in bedroom #3. Hot water temperature was measured from the bathroom sink at 109.4 and 110.3 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas : These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. There is a fireplace that is properly screened. The fireplace is non-functional. No key to the fireplace, and fireplace tools were not present. Seating such as couches where in good repair and sit the capacity of the facility. MEDICATION: The medication will be kept in a locked cabinet located in the hallway. Garage/ Laundry Area: The garage was observed to be used as storage. LPA observed many storage cabinets and extra refrigerator. LPA also observed the washer/dryer appear to be in good condition. Laundry supplies will kept locked in the locked cabinet. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility backyard has sufficient yard space. There is no swimming pool or bodies of water . The side gate was checked to ensure it was clear of obstruction Staff and resident files: Staff and resident files will be kept and maintained in a locked cabinet in garage cabinet. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.