Pre-licensing visit·October 22, 2024

Licensing Program Analysts (LPAs) Marcella Tarin and Maria (Mita) Partoza arrived unannounced to conduct the facility's pre-licensing visit. LPAs met with Anshu Gupta (Vice President/Applicant) and Rose Anne Roxas (House Manager/Administrator). There are 21 residents present on site. This facility address is currently licensed (435294274) and is under a change of ownership. During visit, LPAs toured the inside and outside of the facility to include the kitchen, dining, living room, garage, activity room, 22 resident rooms, 2 staff rooms, 1 office room. 6 out of 22 resident rooms have shared bathrooms. 1 out of 22 resident rooms are shared. 21 out of 22 residents’ rooms are single occupancy. All fire exit routes were free and clear of obstruction. LPAs observed 5 storage sheds located on the back and side perimeters of the facility. All 5 sheds are used for storage and not habitual space. Toxins observed secured. Facility has a laundry area inaccessible to residents. Each resident room has their own exit doorway leading out to the perimeter. 16 cameras were observed in public areas: lobby, driveway (Parking lots), facility hallways, exit doors, and all-around perimeter of the facility, kitchen area, and laundry. No cameras were observed in resident rooms, 16 cameras were observed in total throughout the facility. No bodies of water were observed. Bathrooms supplied with hygiene products and paper supplies. LPAs observed the smoke and carbon monoxide detectors to be in working condition. Hot water temperature maintained between 112.4 to 116.9 degrees Fahrenheit. Facility temperature maintained at 73 degrees Fahrenheit. First aid kit supplied with tweezers, bandages, gauze, scissors, and thermometer. Medications are stored in a locked cabinet. See 809-C LPAs observed a nonperishable food supply of 7 days and a perishable food supply of 2 days. LPAs observed sharp supplies in a locked cabinet in the kitchen. The following posters observed to include the emergency telephone numbers, personal rights, and facility sketch. Fire extinguisher was inspected on 03/13/2024. Areas of corrections were discussed during today's visit with the applicant, such as the facility sketch and the Emergency Disaster Plan (LIC610E). LPAs observed the dishwasher in the kitchen was corroded and 2 parking lot cement stoppers were cracked, current licensee, needs to address that equipment and that the physical plant are in good repair with no breaks, cracks of chips. Pre-Licensing is incomplete with corrections/deficiencies to be resolved by 11/6/2024. The applicant stated an order for a dishwasher has been placed. A follow up Pre-licensure LIC809 will be generated upon resolution of corrections/deficiencies. An exit interview was conducted with Anshu Gupta (Vice President/Applicant) and Rose Anne Roxas (House Manager/Administrator. No deficiencies were cited. A copy of this report was provided to Anshu Gupta. End of report