Facility Evaluation Report

Licensing Program Analyst (LPA) Sanjay Vaid conducted an announced visit with applicant Jennifer Zhang. The purpose of the visit was to conduct the CHOW visit.

An application was submitted to CCLD on 9/16/24, for a Change of Ownership of a Residential Care Facility for the Elderly. The requested capacity of 99 residents, (0) ambulatory, (99) non-ambulatory and (0) may be bedridden. Hospice Waiver request was submitted for up to Fifteen (15) residents.

The facility is currently operating under Facility #198603648

The physical plant inspection could not continue today, due to renovation being made at the facility after a water pipe broke and flooded the three residents rooms. Rooms 234,235 and 126 have water damage.

Pre-licensing will be rescheduled for another time. The licensees must have the repairs to the three residents rooms and common areas completed before pre-licensing can be completed.

Licensee must be present during pre-inspection.

Administrator Jennifer Zhang was given copy of this report.