Follow-up·March 11, 2026

Licensing Program Analyst (LPA) Rebecca Borunda conducted an announced case management visit due to a request to change the facility capacity. LPA was greeted by, identified herself to, and discussed the purpose of the visit with Administrator Amirhossein Ansari. A Change of Ambulatory Status application was received by the Department on 1/4/2026, in which the licensee requested a change in ambulatory status from 6 ambulatory residents to 6 non-ambulatory residents, 1 of which may be bedridden in bedroom #1. The Fire Safety Inspection Request was approved by the local fire authority on 2/9/2026. During today’s visit, LPA toured the facility. No residents were admitted to the facility at the time of the visit. The facility sketch was consistent with the current layout of the facility. No immediate health and/or safety concerns were observed. The completed change of ambulatory status request will be forwarded to management for final review and approval. An exit interview was conducted with Administrator Amirhossein Ansari, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).