NJ Facilites

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced case management visit regarding a change in capacity. LPA was greeted by and allowed entry into the facility by caregiver Amanda Habeeb and discussed the purpose of the visit. LPA also spoke with Administrator Aya Ali over the phone. The Licensee applied for an increase in non-ambulatory capacity. The approved Fire Clearance dated 5/29/26 reflects a total capacity of 6 residents in care, 5 of whom may be non-ambulatory and 1 of whom may be bedridden. The Fire Clearance specifies that bedridden is approved in bedroom #3 only. LPA toured the facility and observed it to reflect the updated Fire Clearance and floor plan. No deficiencies were observed or cited during today's today. An exit interview was conducted with caregiver Amanda Habeeb and a copy of this report and the Licensee Rights (LIC 9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 12, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA), Debbie Correia, conducted an announced follow-up Pre-licensing Inspection. LPA identified herself, was granted entrance, and explained the purpose of the visit to Applicant Ali. During today's visit LPA observed and secured photos of a correction to the physical plant to mitigate a potential fall risk to residents in care. LPA Correia also conducted Component III with Applicant Ali. All items reviewed during the inspection process are in compliance. Pre-licensing is complete, and Licensure is recommended pending final review. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) will be provided to Applicant Imperial at the conclusion of the visit, whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Nov 5, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Debbie Correia, conducted an announced Pre-licensing Inspection. LPA met with Applicant Aya Ali. LPA Correia identified herself, was allowed entry into the facility and stated the purpose of the inspection. The facility’s Fire Clearance was granted on May 23, 2025, for six (6) residents ages 60 and above, of whom two (2) may be non-ambulatory, and one (1) bedridden. LPA was accompanied by Applicant Ali during a tour of the facility, which was conducted inside and out. Facility has one or more operating smoke alarms and carbon monoxide detectors that meet statutory standards. Facility has no bodies of water on the property. Residents have clean linen in good repair and a sufficient supply of extra linen. Resident bathrooms were equipped with a toilet, sink, shower, non-slip mats, and grab bars, all in operating and sanitary conditions. Facility is equipped with locked cabinets for medication and toxins. Facility has adequate space for residents in the common area for resident activities, visitation, and resident meetings. In accordance with the Department’s Infection Control, LPA reviewed the facility's infection control plan and is in compliance with regulation. [Continued of LIC 809C] [Continuation of LIC 809] No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons or open-faced heaters accessible to residents. Per the applicant there are no firearms or ammunition stored at the facility. Emergency lighting, and facility telephone were all operational. All fire extinguishers were serviced within compliance. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. The facility also has locked areas for storage of sharp objects and confidential client and staff records. One area (fall risk) observed by LPA was discussed with Applicant that will be rectified for a future visit for recommendation of Licensure. An exit interview was conducted with Applicant Ali to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. Signature below confirms receipt of the reports.the state’s words, verbatim · CDSS document, Oct 27, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 10/7/2025, applicant/administrator participated in COMP II. Identification of the applicant / administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant / administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Oct 7, 2025