Pre-licensing visit·May 30, 2025

On 05/30/2025 at 9:13AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an announced visit to the facility for the purpose of a Pre-Licensing evaluation. I met with Administrator, Zengqun Yang. An initial application to operate an Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 07/06/2024 for a total capacity of six (6) non-ambulatory residents and one (1) bedridden. Fire clearance was granted on 03/18/2025. LPA observed the following: Structure : Facility is a house with five (5) resident bedrooms, three (3) resident bathrooms, living room, dining area and kitchen. There was an attached two car garage in the front of the house. Heating /Cooling System: Central heating and air conditioning system installed with a three split control panel located in three areas of the facility. Bedrooms: Bedroom #2 can be used for bedridden only per fire clearance. All bedrooms including the master bedroom and bedroom #2 will accommodate a bedridden resident and are adequately furnished with bed, chair, 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 : All three (3) bathrooms have working toilets, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. The water temperature was measured at 115 degrees Fahrenheit. Kitchen: The kitchen has adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the kitchen There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator(s)/freezer(s) were in working condition. Kitchen: There was sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry: Laundry room with washer and dryer was located in the garage. Laundry detergents and cleaning supplies were observed in the garage; which can be locked from the interior and exterior door. Living /Family Room: There was a living/family room with a TV and adequate seating for all clients. 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 is self-latching. There is a storage/staff unit in the backyard. All outdoor pathways were free of obstructions. Emergency Phone Numbers and Exit Plan : Facility sketches were observed posted in the main living room area. There was (1) fire extinguisher and two (2) carbon monoxide detectors and nine (9) smoke detectors 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 are located in the dining room cabinet. Medication will be locked in a cabinet in the kitchen area. LPA observed a facility phone and it was verified to be operational. Emergency water supply and food were observed. 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 Zengqun Yang. The facility has met the requirements according to Title 22 regulations and is ready for licensure.