Pre-licensing visit·July 26, 2024

Licensing Program Analyst (LPA) Christine Dolores arrived announced to conduct the pre-licensing inspection. LPA met with Dulce Rose Cera and Syeda Mamoona Omer. The facility has an approved fire clearance for 6 non-ambulatory, in which 1 may bed bedridden. Bedridden residents is approved to reside in room #5. During visit, LPA toured the interior to include 5 resident bedrooms, 1 staff bedroom, bathrooms, living room, dining room, kitchen, garage, and exterior. All fire exit routes are free and clear of obstruction. Exit routes contains ramps. Fire extinguisher last serviced on 02/09/2024. Carbon monoxide detector, complete first aid kit, and emergency lightings observed present. The backyard contains a shed and observed with storage items. Interior temperature maintained at 71 degrees Fahrenheit. Kitchen is equipped with a locked cabinet to store items that will be kept inaccessible to residents. LPA observed sufficient cups, plates, bowls, and utensils. Facility is equipped with at least 7 days worth of non-perishables and 2 days worth of perishable foods. Refrigerator temperature maintained at 37 degrees Fahrenheit. Freezer temperature maintained at -1 degrees Fahrenheit. Bedrooms equipped with beds, linens, adequate lighting, chair, night-stand, and dresser. Hot water temperature maintained at 106 degrees Fahrenheit. Bathroom shower contains non-slip mats. Bathroom #1 and #5 observed with a grab bar. Laundry room observed with locked cabinets. Facility has an area to lock medications and records. Posters observed to include the licensing complaint poster, ombudsman, personal rights, rights of resident council, house rules, activities, and emergency disaster plan. COMP III completed with Dulce Rose Cera, Syeda Mamoona Omer, and Syeda Lubna Haroon No issues noted during the pre-licensing inspection. LPA observed the facility is ready to be licensed. However, this report will be submitted to the Central Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. This report was reviewed with Dulce Rose Cera and Syeda Mamoona Omer and a copy of the report was provided.