Pre-licensing visit·September 15, 2023

Licensing Program Analyst (LPA), Zabel Chochian conducted a pre-licensing visit to this property on today and met with Kemi Osilesi, Applicant Representative and her assistant Omowunmi Balogun. Upon arrival LPA and applicant reviewed the application and discussed the plan of operation. Applicant acknowledged understanding the importance of operating according to the regulations and laws applicable for licensure. The applicant has obtained fire clearance for a total capacity of six(6) bedridden resident. A Fire Clearance was approved on 08/11/2023. Component III Orientation was completed during today's visit. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. At approximately 10:30am, all hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. LPA observed two (2) fire extinguishers to be new and fully charged. Required postings, including emergency exit plan, Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights. There are two (2) single occupancy bedrooms and two (2) double occupancy bedrooms for resident use. There is a staff bedroom for live in staff. Each bedroom is equipped with clean mattresses, pillows, and bedding. There is sufficient supply of linens, including blankets, bath towels and wash cloths. Bedrooms have sufficient lighting. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in the bathrooms. Appliances and all equipment appear to be clean and in good repair. Kitchen knives are stored in a locked drawer. Cleaning supplies stored locked and inaccessible. The kitchen has a sufficient supply of plates, cups, cook ware and utensils. The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. Enough seating for six (6) residents at the same time in the dining room table. A working telephone is present. There are activity supplies for future residents. Night-lights were present in the main hallway and common areas. Medications will be stored in the kitchen cabinet, locked and inaccessible. Facility records will be stored and locked in a cabinet in the office. New first aid kit was at the facility. continue to LIC809C page... Garage: The garage is attached to the house and will be locked at all times. The laundry room is inside the garage. Detergents, disinfectants, and cleaning supplies shall be stored and inaccessible. There will be no firearms/ammunition stored on the property. All exit door alert system needs to be operable. During today visit Applicant contacted technician to install the system and ensure all door alarms are working. The exterior passageways and exits were clean and clear of any obstructions. However there are items stored in the backyard that need to be removed to clear space for residents safety; the two side exits need a self-latching mechanism installed on both gates. There are no bodies of water on the premises at the time of the visit . Backyard has a outdoor area space for residents use which applicant stated that she has ordered table and chairs for resident use. Applicant also mention that the section of the backyard that is undone will be used to build an ADU. Applicant plans to apply for a facility license for the ADU once it is built. LPA advised applicant to consult with city zoning and ensure all permits are obtained. Also applicant was reminded that the department shall be notified prior to any work done on the property as well as a plan on how they'll will ensure the health and safety of residents in care and daily living is not disturbed. Applicant agreed to install a gate to separate the backyard area that is to be used for an ADU from the area where residents will be using for outdoor space leisure. Applicant was informed of the following corrections needed: 1) Clear backyard of all debris and materials (submit photo). 2) Install self-latching mechanism on side gates (submit photo). 3) Install fencing to separate backyard from future ADU area and current space that will be used for residents (submit photo). 4) Proof of door alarm installation and confirm that it is working (submit photo and self certification letter). This report will be sent to the Centralized Application Bureau (CAB). Once the corrections are cleared you will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. A copy of the report was reviewed and provided.