Pre-licensing visit·September 25, 2025

Licensing Program Analysts (LPAs) Blanca Gonzalez and Nune Margaryan conducted an announced Pre-Licensing Inspection visit and met with Administrator Pamela Ogot, Chief Executive Officer Tillman Pink Jr and Quality Assurance Director Melissa Flores. This Pre-Licensing Inspection is due to a change of ownership. The facility has an approved fire clearance to be licensed to serve twenty-four (24) non-ambulatory residents and ten (10) bedridden for a total capacity of 34 adults aged 60 and older. Bedridden rooms are #3, # 4, #7, #8, #12 and #14. The facility has a census of 5 residents. LPAs and Applicant toured the physical plant interior and exterior. The following was observed/inspected: The facility is in a residential neighborhood of Glendora and consists of 17 resident bedrooms, 13 bathrooms, kitchen, living room/dining room/activity room, medication room, nurse station, administrator office, conference room, lobby, reception area and garden/outdoor area. The facility temperature at the time of visit was comfortable. Required postings observed in the hallway. Auditory devices on doors leading to exterior were observed and operable. No delayed egress on exterior doors. continued on LIC 809C continued from LIC 809 (page 2) Smoke detectors and four (4) fire extinguishers were observed throughout the facility. The facility is equipped with a fire alarm and sprinkler system. A carbon monoxide detector was observed in the hallway, was tested and is operable. A secured hallway closet contained cleaning supplies, toxins and disinfectants that were inaccessible to residents. Dining room/living room/activity room were observed clean and comfortable with sufficient seating for residents in care. Vending machines observed in dining area. LPAs observed sufficient space to accommodate both indoor and outdoor activities. Activities calendar was posted in the hallway. Garden/outdoor area was easily accessible to residents through the dining room, protected from traffic, but did not have adequate shaded seating areas. Outdoor furniture was dirty with bird droppings and seat cushions were in disrepair. Passageways were clean and free of obstructions. No pools or large bodies of water. Kitchen was observed clean and free of litter, rodents, vermin and insects. Refrigerator and freezers were observed clean and operating at time of visit. Currently, due to only having five (5) residents, meals are not prepared on site. Prepared meals are brought from sister facility in Monrovia. Pantry was observed to have enough non-perishable food supply for 7 days. Centrally stored medications are maintained in a secured med room inaccessible to residents. Medication room was inspected and medication was reviewed. Locked laundry room was observed to be clean and detergent secured. Washing machine and dryer were in working order. Extra clean linens were observed in linen storage area. LPAs inspected all bedrooms (occupied and non-occupied) and observed that a few resident bedrooms did not contain the required furniture. Bed linens were clean and in good repair. There was closet space for clothing and other belongings. Bedroom #14 is designated for bedridden and is currently used and furnished as an activity room. continued on LIC 809 C (page 3) Resident bathrooms were observed clean. Grab bars and non-slip mats observed in all bathrooms besides the bathroom located in the hallway for residents to use for bedrooms #17 and #18. Also, the water temperature measured 129°F, which is not within the required range of 105-120°F and did not have grab bars in the shower. Resident bedrooms #17 and #18 located at the back of the facility are attached to the main building, connected by the laundry room. Rooms #17 and #18 have additional access through the Garden/outdoor area accessible through the dining room. LPAs observed that the area where Rooms #17 and #18 are located did not have smoke detectors (need clarification). The following Corrections need to be made prior to clearing the facility for License: • Outdoor furniture must be cleaned and seat cushions in good repair • Adjust water temperature in bathroom for rooms #17 and #18 to measure within the required range of 105-120°F • Add grab bars to shower in bathroom for rooms #17 and #18 • Convert room #14 from activity room back to resident bedroom, as described on facility sketch • Licensee will ensure all 17 resident bedrooms contain required furnishing consisting of: for each resident, a chair, nightstand, a lamp, or lights sufficient for reading, a bed including blankets, bedspreads, top bed sheets, bottom bed sheets, pillow cases, mattress pads. Pre-licensing is incomplete with corrections to be resolved by October 6. Facility administrator will advise LPA of corrections. A follow up inspection to verify corrections have been made will be conducted. Exit interview conducted and a copy of this report was provided to Administrator Pamela Ogot. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.