Pre-licensing visit·April 3, 2026

On 04/03/2026 at approximately 1:00PM Licensing Program Analyst (LPA) Ali Deniz conducted a pre-licensing inspection and was greeted by Applicant, Issa Shehadeh. This pre-licensing inspection is being conducted for an initial licensing. The facility is a single-story home with 5 resident rooms, 3 bathrooms, and common areas. Facility received an approved fire clearance dated 02/04/2026 that allows for a total capacity of 6 residents, where four (4) can be non-ambulatory, one (bedridden), and one (1) can be ambulatory. The facility currently has no clients in care at the time of this visit. LPA conducted a tour and inspection of the indoor and outdoor portions of the facility. The facility was found to be clean and comfortable temperature with bedroom doors free from obstruction. Facility has an Infection Control plan on file. LPA observed Fire extinguishers located on the kitchen wall which were bought new inspected on 04/03/2026. Cleaning products, sharp items, other toxins and chemicals are kept in the kitchen cabinets and laundry room were secured and locked. Additional supply of hygiene products available to residents. Water was measured at 117-degrees and 1115-degrees F in faucets used by residents which is within regulation between 105- & 120-degrees F. LPA observed one all bathrooms did have grab-bars and non-slip bath mats. Mattress pads were in place or available for residents use. All emergency exits were found to be unobstructed. Facility has combination smoke and carbon monoxide detectors which were operational during visit. LPA confirmed that the contents of the facility's First Aid Kit were sufficient. The facility had emergency lights, and emergency water supplies were available on site. LPA also observed facility emergency lights. LPA observed amount of non-perishable food was low, the applicant ordered over the application and showed the receipt to LPA. Continued on LIC809-C page... Continued from 809 page... The facility has an adequate supply of kitchen tools. Per conversation with applicant, sharps such as knives will be stored and locked in the facility all the time. LPA observed a medication cabinet with lock in the facility dining room. Per conversation with applicant, resident's medications will be locked all the time. LPA observed the required postings including emergency disaster plan, the Let Us Know Complaint poster and See Something Say Something poster. RCFE Component III was reviewed with Applicant. No Deficiencies or Advisories given during visit. Pre-Licensing completed. Facility is ready to be Licensed as an Residential Care Facility for Elderly (RCFE). LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicants of Status. Exit interview conducted. Copy of report discussed and provided to Applicant. The signature on form confirms receipt of documents.