Post-licensing visit·July 28, 2025

On 7/28/2025 at 8:39 AM, Licensing Program Analyst (LPA) Cynthia Tamayo arrived at the facility for an announced to conduct a Post-licensing inspection. LPA was greeted by staff member, Sudien Crooks and explained the purpose of the visit. Facility Designated Administrator (FDA), was contacted by staff and arrived at approximately 9:15 AM. Sherry Ahuja to inform them that CCL was present at this time. LPA Cynthia Tamayo met with applicant Sherry Ahuja and explained the purpose of the visit. Sherry holds an active administrator certificate # 6062188740 and is valid until 01/30/2026. Current census was 2. This facility is licensed to serve six(6) non-ambulatory residents of which, one(1) may be bedridden in room #5. Waiver/granted for hospice care for (6). There is one staff bedroom and one staff office that are inaccessible to residents. There are currently no residents on hospice at this time. LPA reviewed 2 out of 2 resident files and 2 staff files. Resident and staff files were complete. Hot water temperatures were taken to ensure it was in the regulation of 105-120 degrees and it measured at 105.4 * F. Carbon monoxide and smoke alarms were present and were in working condition. A menu was observed in the kitchen area. Common areas for resident use were toured. Furniture and furnishings were observed to be present and in compliance. 76 degrees Fahrenheit which is within the required range of 68-85 Fahrenheit. Grab bars and non-skid mats were present and functional. Resident bedrooms were toured. Furniture and furnishing were observed to be present and in good condition. Continued on 809-C A linen closet was located in the hallway and had sufficient number of linens at this time. The kitchen area was toured. Facility freezer and refrigerator showed to be functional. LPA Tamayo observed that there were not 7 days of nonperishable food in the pantry. LPA Tamayo observed the centrally stored medications area to be locked and inaccessible to residents. The fire extinguisher(s) and first aid kits were up to date. fire extinguisher will need a re-service/replacement 12/23/2025. Smoke and carbon monoxide detector(s) were in good repair. An activity Calendar was observed in the common areas. There is no longer a Jacuzzi hot tub located in the backyard. Two self latching gate doors observed in the backyard. As a result of this post licensing visit, the facility is in compliance with Title 22 Regulation. An exit interview was conducted with Sherry Ahuja, and a copy of these LIC 809 reports were provided to the facility.