Pre-licensing visit·December 30, 2025

Licensing Program Analyst (LPA) Arian Golbakhsh conducted a subsequent scheduled Pre-Licensing Inspection and Component III Training. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Licensee Kamran Banayan and Administrator Alice Millan. The facility's planned capacity is for six (6) non-ambulatory clients, one (1) of which may be bedridden. Bedridden resident may only reside in bedroom #3. As the facility is not yet licensed, during today’s inspection there were zero (0) clients in care. LPA, Licensee Banayan, and Administrator Millan toured the interior and exterior of the facility and inspected each room. Facility sketch was consistent with the current layout of the facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: One common bathroom sink was measured at 110F and kitchen sink read at 106F. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility was prepared to contain at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. LPA observed a locked drawer for safe storage of knives and similar sharp objects. [Continued on LIC 809-C] [Continued from LIC 809] No toxic chemicals or poisons were accessible to clients. Centrally stored medication cabinet was locked, per regulation. No pools or bodies of water exist on the premises. Per Licensee Banayan, no firearms or ammunition are kept at the facility. Smoke and carbon monoxide detectors and emergency lighting were all in working order. Fire extinguisher was purchased within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA re-inspected the backyard deck railing and observed improvements made. Additional height and railings were added, thus mitigating the safety concerns previously noted during previous pre-licensing inspection conducted 12/11/25. LPA conducted the Component III Training with Licensee Banayan and Administrator Millan. LPA also answered additional questions regarding regulations and responsibilities and provided resources for Licensing Forms and best practices. No immediate health and/or safety concerns were observed during today's visit and LPA determined the facility is ready for residents. The facility's request for licensure will be forwarded to management and the Centralized Application Bureau (CAB) for final review and approval. If and once granted their license, licensee will notify LPA within seven (7) days of receiving their first client. An exit interview was conducted with Licensee Banayan to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.