Woodlands Iv

On 04/10/2025 at 12:15 PM, Licensing Program Analysts (LPAs) David Doidge and Ardalan Gharachorloo arrived to conduct 1-Year Annual Required inspection. LPAs met with caregiver Rio Clark. and explained the purpose of the visit. The Administrator Administrator Tayyaba Chaudhry arrived at the facility at 01:10 PM. During the visit, LPAs toured facility including but not limited to the kitchen, dining room, resident bedrooms and bathrooms, front and back area of the facility, and common areas. Fire extinguisher was observed full and last inspected on 11/26/2024. Smoke detectors and carbon monoxide detectors were tested and observed functional. LPAs observed the facility to be at 65 degrees Fahrenheit. All indoor and outdoor passageways are kept free of obstruction. Hot water temperature was measured at 109 degrees Fahrenheit. LPAs observed skid mats and grab bars in resident bathrooms. LPAs observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in or around the facility. LPAs observed a sufficient supply of 7 day non-perishables and two day perishable food supplies. LPA reviewed six (5) resident files and five (4) staff files; all were complete. The last fire and earthquake drills were conducted on 12/10/2024. Centrally stored medications were observed locked in a cabinet. First aid kit was observed to be complete . No deficiencies were cited during this inspection. Exit interview conducted and a copy of this report provided.

On this day at around 10:45 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct pre-licensing inspection. Licensee/Applicants Tayyaba and Ejaz Chaudry arrived at the facility at around 12:05 pm. During the visit, LPA toured the facility with the applicants. Physical plant is consistent with the facility sketches submitted to Centralized Application Bureau (CAB). There is no body of water observed. There were 6 resident bedrooms and 2 bathrooms that were observed with adequate lighting. There is an additional room and bathroom that will be for staff use. Facility is equipped with refrigerator, microwave, dishwasher, washer and dryer. There was sufficient supply of plates, glasses, and other utensils. Facility land line telephone was tested and observed operational. Towels, sheets, warm blankets and hygiene products were observed available. Fire extinguishers that appeared full and were last serviced on 11/1/2023 were observed. First aid kit was observed complete with manual. Flashlights were observed available for use. Licensee/Applicant states all residents will have a call button that is connected to a monitor in the kitchen. The following were observed during the inspection: missing carbon monoxide missing required posters such as Complaint poster, Personal Rights, Theft and Loss, etc hot water measured at 129.3 degrees Fahrenheit workers were observed in the front yard fence on the right side facing the facility is leaning towards the neighbor's side screen doors/windows/pieces of wood were observed in the side yard continuation on Lic 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 The Licensee/Applicant will send CCL photos of corrections. In regards to the fence, Licensee/applicant states he is in contact with the neighbor and will update CCL. LPA will inform CAB analyst upon receipt of proof of corrections. Final review of application, and license to be granted by CAB. Exit interview was conducted, and copy of this report was provided to the applicant.

COMP II by CAB successfully completed Method: Phone Call at CAB Facility Type: RCFE Capacity: 6 Census (if any clients in care): Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of property