Pre-licensing visit·December 3, 2024

Licensing Program Analysts (LPA) Jerome Haley made an announced visit for the purpose of conducting a pre-licensing evaluation. LPA Haley was greeted and granted entry by applicants Hashim Moosani and Saleem Moosani. Structure: The facility is a single level structure, with an attached garage. There’s a total of 4 bedrooms (3 resident and 1 staff), one living room space, one dining area, and two bathrooms. Bedrooms (Residents): All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Grab bars are tightly secured. Hot water temperature measured at 119.6 degrees Fahrenheit in bathroom 1 and 117.8 degrees Fahrenheit in bathroom 2. Kitchen: 4 of 4 burners were operational on the gas stove. Sharps are locked in a kitchen drawer near the stove. Hazardous chemicals are locked under the sink. Food Service: There’s a perishable food supply that meets regulation requirements. A nonperishable food supply was observed. Laundry: There's a laundry area in the garage with a washer and dryer. Toxins: All toxic chemicals and cleaning solutions are locked under the sink in the kitchen or in the garage and inaccessible to residents in care. Resident & Staff Files : Resident and staff files are stored in a locked cabinet above the locked medication cabinet in the kitchen. Medications/First-Aid Kit: Medications are store in the kitchen in a locked medication cabinet near the refrigerator. There’s a first aid kit equipped with all the necessary elements in the locked medication cabinet. Linens & Hygiene Supplies: An additional supply of linen is stored in the garage. Backyard/Exterior: There’s a large backyard with self-latching side exit gate. A shaded patio area with a table and reclining style chairs was observed. Additional chairs and tables were observed on the patio area. Bodies of Water: No bodies of water observed. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Continued on LIC809C Fire Extinguisher: Observed full charged mounted on the wall in the kitchen near the dining room. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Are posted on the wall near the entrance. Readily available for review is an emergency disaster plan, a list of emergency phone numbers, and personal rights. A sample menu is posted in the kitchen on the refrigerator. Component III: Is not ready to be presented at this time. Component III will be presented after corrections are made and the follow up visit is completed. Corrections: The applicant has corrections to make before the facility is ready to be licensed. 1) Repair or replace the fan/light on the stove/oven. Fan/light is not operating. 2) Remove/cover exposed wires in the living room (ceiling) & bedrooms (ceilings) 3) Clean all ceiling fans 4) Replace missing blinds in the living room sliding glass door. 5) Additional non-perishable food items (can goods) 6) Non-skid matts for showers A follow up visit will be scheduled one Applicants have completed the necessary corrections. An exit interview was conducted, and a copy of this report was provided to applicant Saleem Moosani.