Pre-licensing visit·October 23, 2025

Licensing Program Analyst (LPA), Debbie Correia, conducted an announced Pre-licensing Inspection. LPA met with Applicant and Administrator Imperial, LPA Correia identified herself, was allowed entry into the facility and stated the purpose of the inspection. the facility’s Fire Clearance was granted on August 4, 2025, for six (6) residents ages 60 and above, all of whom may be non-ambulatory. LPA was accompanied by Applicant and Administrator Imperial during a tour of the facility, which was conducted inside and out. Facility has one or more operating smoke alarms and carbon monoxide detectors that meet statutory standards. Facility has no bodies of water on the property. LPA observed a seven-day supply of non-perishable food items. Residents have clean linen in good repair and a sufficient supply of extra linen. Resident bathrooms were equipped with a toilet, sink, and shower in operating and sanitary conditions. Facility is equipped with locked storage area for medication and toxins. Facility has adequate space for residents in the common area, and outdoor shaded area for resident activities. In accordance with the Department’s Infection Control, LPA reviewed the facility's infection control plan and is in compliance with regulation. [Continued of LIC 809C] [Continuation of LIC 809] No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons or open-faced heaters accessible to residents. Per the applicant there are no firearms or ammunition stored at the facility. Emergency lighting, and facility telephone were all operational. All fire extinguishers were serviced within the last twelve (12) months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. The facility has sufficient space and equipment to facilitate laundry, visitation, and resident meetings. The facility has locked areas for storage of sharp objects and confidential client and staff records. One area (trip hazard) observed by LPA was discussed with Applicant and Administrator Imperial that will be rectified for a future visit, along with the review of Component III, for recommendation of Licensure. An exit interview was conducted with the Applicant to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. Signature below confirms receipt of the reports.