Pre-licensing visit·July 14, 2025

On 7/14/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived announced at this facility to conduct the prelicensing inspection visit. LPA met with Licensee/Administrator Andre Albason, and stated the purpose of the visit. Overview : Facility is a one-story home located in a residential neighborhood. Facility will be licensed to serve up to 6 elderly residents, 2 of which are ambulatory and 4 are non-ambulatory . Facility has 4 resident bedrooms and two resident bathrooms. Bedrooms #2 and #3 may be occupied by non-ambulatory residents provided bedroom #4 has no privacy lock as the exit door in bedroom #4 shall be accessible in case of an emergency. Outdoor Area: Front yard was observed to be maintained and clear of debris and obstruction. There is an area in the backyard equipped with outdoor furniture with umbrella located next to a tree for shade. Outdoor passageways, walkways, driveways, and steps are free from obstructions. Fence and gate are in good repair. No swimming pools/bodies of water at this time. Residents' Bedrooms: LPA inspected 4 resident bedrooms and were observed to be equipped with the required furniture and sufficient lighting throughout. Each bedroom has smoke and carbon monoxide detector. Resident bedroom #1 is located near the front door. A fire door was observed leading to the other resident bedrooms. Bedrooms #1 and #3 will be single occupancy. Bedrooms #2 and #4 will be shared. Bedroom #4 has its own bathroom and exits the backyard. This exit will be accessible as an emergency exit. {Con't to 809-C} {Con't from 809} Bathroom: Facility has 2 resident bathrooms. One bathroom in the hallway and the other bathroom is inside bedroom #4. Both bathrooms have working toilets, wash basins and full baths with showers. Both bathrooms are equipped with non-skid flooring and close-lid garbage bins. LPA provided an advisory to install a grab bar in the toilet area for the bathroom in bedroom #4. It was installed during this visit. Linens & Hygiene Supplies: Adequate supply of linen and hygiene supplies stored in linen closet, located in the resident hallway. Emergency Phone Numbers, Exit Plan & Menu : Emergency Disaster Plan will be posted & available for review. Two fully charged fire extinguisher were found in the kitchen/dining room and in the resident hallway. Fire extinguishers were last serviced on 1/22/25. Dangerous Items: Toxins and chemicals were locked/stored under kitchen sink and in the laundry area and are inaccessible to residents. Water temperature: Hot water temperature was taken in one bathroom and measured at 105*F. Food Service: Dishes, cups and flat ware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are in locked drawers. Smoke Detectors and carbon monoxide: Facility has smoke detectors/carbon monoxide monitor combination. LPA observed one in each resident bedrooms, hallway, living room and in the kitchen/dining room area. They were tested and found in good repair at this time. Appliances : Stove burners and oven are in good working condition. There is 1 refrigerator/freezer in the kitchen. Advisory was provided to obtain thermometer for both the refrigerator and freezer to ensure regulatory temperature is maintained for proper food storage. Washer and dryer are located in the laundry room, leading to the garage area. Medications, First-Aid Kit & Records: First aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and manual which are stored in locked cabinet in the kitchen/dining area, available for staff use but inaccessible to residents. There is a medication cabinet that was observed to be locked. Residents & Staff Files: Applicant will not be handling cash resources of residents at this time but will submit necessary documents for any changes. {Con't 809-C} {Con't from 809-C} Activity Supplies/Materials: During this visit, LPA observed Bingo, Connect Four, Jenga, and books. Advisory was provided for licensee to provide future residents with a variety of activities and choices. Component III: LPA reviewed Component III with Andre Albason. The applicant has passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. An exit interview was conducted and a copy of the report was provided.