Pre-licensing visit·August 6, 2025

On 08/06/2025 at 9:30AM Licensing Program Analysts (LPAs) Renese Howell-Small and Edith Conchas conducted an announced visit to the facility for the purpose of a Pre-Licensing evaluation. I met with Administrator/Licensee, Ahmed Qasim. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 12/01/2024 for a total capacity of fifteen (15) residents, 10 ambulatory and (5) non-ambulatory. Fire clearance was granted on 02/04/2025. LPAs observed the following: Structure : Facility is a house with (8) resident bedrooms, two (2) resident bathrooms, living room, dining area and kitchen and backyard. Heating /Cooling System: Central heating and air conditioning system installed with three control panels located in the hallway. Bedrooms: All bedrooms are adequately furnished with bed, chair, closet, appropriate linens, adequate lighting and licensee/administrator will install night lights in the hallway. Bathrooms : All 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 116 degrees Fahrenheit. Kitchen: The kitchen has an adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the kitchen drawer next to sink. There was adequate room for food storage. LPAs observed the stove to be operational. Refrigerator/freezer 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 near the main hallway. Laundry detergents, cleaning supplies and personal care items are kept locked in the laundry room. 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 living room area. Yards/Outdoors: There is sufficient covered seating area in the backyard. There is a gate on the left and right side of the facility. The gate on the left side is the exit and is self-latching. All outdoor pathways were free of obstructions. Emergency Phone Numbers and Exit Plan : Facility sketches were observed posted in the kitchen area . There were four (4) fire extinguishers, carbon monoxide detectors and smoke detectors which are working and in good condition. General items: Client records will be stored in a locked cabinet in the office area. First Aid kit with required components are located in the medications cabinet. Medication will be locked in a cabinet in the office area. LPAs observed a facility phone and it was verified to be operational. Emergency water supply was observed. Administrator will complete a emergency food/supplies container. 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 Administrator Ahmed Qasim. . According to Title 22 California Code of Regulations, Licensee/Administrator Ahmed Qasim has satisfied all of these requirements and is ready for licensure.