Bloomora Grove

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Luis De Leon conducted an announced pre-licensing inspection. LPA met with Vincent Okorafor and Ogochukwu Okorafor applicant/administrator. The applicant is applying for a Residential Care Facility for the Elderly to serve residents for the age range from 60 years and over. This is an initial application. The requested capacity is six (6) non-ambulatory residents of which one (1) may be bedridden in any room on first level. A waiver has been granted for hospice care for six (6) residents. Currently, there are no residents residing at the facility. Physical Plant: The physical plant is a two-story family residence located in a residential neighborhood. First floor: There are four (4) residents’ bedrooms (Rooms 2, 3, 4, and 5), bedridden residents can be placed in any of these bedrooms. Bedrooms 1 and 6 on floor plan are designated for activity room and conference/office room. Additionally, the first floor has a kitchen, dining room, living room, reception, and laundry room. There are four (4) full bathrooms, and one (1) half-bathroom. Second floor is not accessible to residents and access to stairs is locked from residents. Second floor: two staff bedrooms and one bathroom. Passageways, walkways and patios are free from obstructions. The entrance and side areas are free of hazards and debris. There is an attached car garage on the facility. Fire clearance: Fire clearance is granted as of 12/26/2025 for five (5) non-ambulatory and one (1) bedridden resident. Each bedroom is equipped with a smoke detector. The facility is equipped with a carbon monoxide detector. Two (2) fire extinguishers are fully charged and last serviced on 06/21/2025. (continued on LIC-809C) Outdoor activity area in backyard: Outdoor activity area is furnished with chairs and tables and in compliance. A shaded area in the backyard at the outdoor activity area is provided. Facility, Residents & Staff Files: Locked cabinets for records of staff and residents are installed and available in the front office. Licensee will update liability insurance policy to show facility's name and submit a copy of new policy to regional office. Water Temperature/ Fire extinguishers: Bathrooms are clean and operational. The hot water temperatures were tested in all resident bathrooms and were within the required range of 105-120 degrees F in compliance with Reg Title 22. Kitchen and phone: The kitchen was inspected, and kitchen appliances were observed to be working properly. Cleaning items will be kept locked in a cabinet inside the laundry closet and under the kitchen sink and inaccessible to residents. Sufficient disposable cups, plates and cutlery were observed. Knives/sharps are secured inaccessible to residents. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Food menus are available for review. Landline telephone and internet are available for residents’ use and operable. Health Related Services: First Aid Kit was observed and locked cabinets were observed for storing residents’ medication. Disaster Preparedness: Facility has an emergency disaster plan in place. The facility is prepared with flashlights and emergency lighting for residents to use during power outages. Bodies of Water: There was no body of water observed on property. Findings/ Exit: No issue was observed during today’s visit. Exit conference was conducted. LPA conducted Component III orientation to applicants during the pre-licensing visit. A copy of this report was provided to applicants. LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, s/he has been instructed to communicate with the CAB Analyst who assigned to his/her application.the state’s words, verbatim · CDSS document, Apr 23, 2026

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Initial Interview Method:Virtual interview (Microsoft Teams) On March 27, 2026, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and 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 and 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, Mar 27, 2026