Pre-licensing visit·March 5, 2026

Licensing Program Analyst (LPA) Maria (Mita) Partoza arrived announced to conduct the facility's pre-licensing visit for change of ownership (CHOW). LPA met with applicant Kim Nelson Jinon and current licensee Belinda Devano. There are 5 residents present at the facility. This facility address is currently licensed (Touch of Life Residential - 435202666) to serve adults 60 and over capacity of 6, 5 non-ambulatory of which 1 may be bedridden in room #3 only, has a hospice waiver approved for 4 residents. Applicant stated that he/she applied for 5 hospice waiver during initial application. Facility has an approved fire clearance for capacity of 6 resident, 5 of which are non-ambulatory and 1 bedridden in bedroom #3 only. During visit, LPA toured the inside and outside of the facility to include the kitchen, dining, living room, garage, resident rooms and 2 bathrooms. Garage and second floor are off-limits to residents. The laundry area is located inside the garage. All fire exit routes were free and clear of obstruction. Medication, chemicals, sharps were in a locked cabinet not accessible to residents in care. The first aid kit has it's own cabinet accessible to staff. Bathrooms were supplied with hygiene products and paper supplies has grab bars and anti slip mats. LPA observed smoke and carbon monoxide detectors are in working condition. The following posters observed to include the emergency telephone numbers, personal rights, and facility sketch. page 1 of 2 LPA observed a ramp on the side of the facility building that was sturdy and maintained. The backyard was maintained and no hazardous materials were observed. LPA observed the exterior walkways are free from obstructions. Water temperature was within regulatory range of 114.4 to 116.4 when measured with a digital thermometer. The facility temperature is at 68 to 70 degree F. LPA observed 2 days of perishable and 7 days of non-perishable foods. The facility is sanitary and maintained. LPA observed no tripping hazard in the hallways. All exits door from the inside are free from obstruction. Resident rooms have sufficient storage to store personal belongings. Currently the facility has 1 bedridden resident in room #3 and 4 residents under hospice care who uses hospital beds with full bed rails. The exit door on the hallway by Bedroom #3 has self-closing mechanism. Component III was presented and discussed with applicant. Pre-licensing inspection is completed, this facility has no deficiencies observed. Report will be submitted to the Central Application Bureau (CAB) and a final review of the application will be conducted. This facility Harmony Life Care Inc., is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. An exit interview was conducted with applicant Kim Nelson Jinon and current licensee Belinda Devano, and a copy of the report was provided. page 2 of 2 end of report