Pre-licensing visit·January 21, 2026

On January 21, 2026 Licensing Program Analyst (LPA), Deborah Lee conducted an announced visit to the facility for the purpose of conducting a pre-licensing evaluation. An application was submitted to CCLD, for opening an Residential Care Facility for the Elderly (RCFE). Fire clearance approved for capacity of 6 residents 60 and over residents (2 ambulatory and 4 non-ambulatory) on October 8, 2025. LPA met with Lotanaka Williams, Applicant and explained the purpose of today’s visit. LPA and Applicant toured the physical plant (inside and outside). Overview of Facility: Facility is one story home located in a residential neighborhood. Entry way of the home is clear and free of debris and obstruction. There are 4 resident rooms , 3 bathrooms, living/common room, dinning room, kitchen, Laundry room (located in staff bathroom area), and detached garage which is rented out and not used by facility). The bedrooms are spacious and easily accommodate the residents' furnishings. LPA observed that there are no bodies of water on the premises. The shaded area and outdoor passageways, walkways, driveways, steps and patios are free from obstruction. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. Resident Bedrooms: Bedrooms 1-4 have working lights, working windows with no bars. There will be 2 private and 2 shared rooms. Page 1 of 2 Bathrooms: All Bathrooms have a working toilet, wash basins and shower, and observed to be clean, safe, and sanitary. LPA observed adequate lighting throughout the entire facility. Linens & Hygiene Supplies: Extra linens are available to residents when need and located in residents bathrooms. Living/common room is fully furnished with 5 recliners, mounted TV, covered fireplace. Dining area is equipped with a 4 seated dinette set. There is adequate space for the residents. Kitchen is clean and sanitary with appliances that are operational. LPA observed 7-day supply of non-perishables foods and 2-day supply of perishable food. LPA observed the area where sharp objects and cleaning solutions will be locked and inaccessible to the residents in care. The Facility has a lanline phone for emergencies. There are 3 fully charged fire Extinguishers inside the home. LPA observed all required postings: See something say something, resident rights, emergency disaster plan, facility sketch and exit signs Resident/Staff files: LPA observed that there is a confidential storage area where staff and resident files will be kept it will be securely locked in a file cabinet. Medications: LPA observed that there is a locked centralized area where residents' medications will be stored. Located in locked cabinet near kitchen area. Smoke Detectors: Facility has 9 smoke detectors/carbon monoxide detectors are hardwired and interconnected. They were tested and operable. Water Temperature: Tested between 105-120 degrees F. There are no corrections needed. Component III: Conducted during today’s Pre-Licensing visit. Page 2 of 2