Pre-licensing visit·July 3, 2025

On 07/2/2025 at 9:30 am Licensing Program Analyst (LPA) Beena Singh conducted an announced visit to the facility for the purpose of a Pre-Licensing evaluation. LPA Singh met with Administrator LEA EBUENG. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 09/25/2024 for a total capacity of six (6) two ambulatory (2), two (2) non-ambulatory and two (2) bedridden residents. Fire clearance was granted on 12/06/2024. LPA observed the following: Structure : The facility is a one storey house with four (4) bedrooms, two (2) resident bathrooms, a living room, dining area and kitchen. There was an attached two car garage on the front of the house. Heating /Cooling System: Central heating and air conditioning system installed with a control panel located in the garage of the facility. Bedrooms: Bedrooms will accommodate two (2)ambulatory, two (2) non-ambulatory and two (2) bedridden residents are adequately furnished with bed, closet, appropriate linens and adequate lighting. Night lights were observed in the facility and will be placed in the hallways leading to residents' shared bathrooms. Bathrooms : There are two (2) bathrooms for the residents which have working toilets, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. The water temperature was measured at 110 degrees Fahrenheit in the resident’s bathroom. Kitchen: The kitchen has an adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp and hygiene care items were secured in a locked drawer located in the kitchen. There was an adequate room for food storage. LPA observed the stove to be operational. Refrigerator(s)/freezer(s) were in working condition. There was sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry: Laundry room with washer and dryer was upstairs. Laundry detergents and cleaning supplies will be locked in the laundry room, which can be locked from exterior door. Living /Family Room: There was a living/family room with a TV and adequate seating for all residents. Residents Activities, pool table and furniture will be placed in the living area for the residents. Linens and Hygiene: An adequate supply of linens was stored in a cabinet in the main hallway of the residence. Yards/Outdoors: There is sufficient covered seating area the backyard. The gate on the right side is the exit and will be locked due to dementia residents. There is a storage/staff unit in the backyard. All outdoor pathways were free of obstructions. All exit doors have operating delayed egress devices. Emergency Phone Numbers and Exit Plan : Facility sketches were observed posted in the main living room area. There were two(2) fire extinguishers and seven (7) carbon monoxide detectors and seven(7) smoke detectors connected with one unit which are working and in good condition. General items: Client records will be stored in a locked cabinet in the kitchen area. First Aid kit with required components is located in the dining room cabinet. Personnel files and medication will be locked in the cabinet next to the television sitting area. LPA observed a facility phone-951-223-3387 and it was verified to be operational. Emergency water supply and food were observed. The facility has met the requirements according to Title 22 regulations and is ready for licensure. An exit interview was conducted, no deficiencies were cited, Component III was completed during this visit, and a copy of this report was reviewed and provided to the Facility Administrator EBUENG, LEA.