Routine inspection·January 22, 2026

On 01/22/2026 at 11:23AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Perla Aplasia, Caregiver and explained the purpose of the visit. Administrator, Jamie Bernardino-Ruiz arrived at 11:58AM. Administrator currently holds certificate #7035384740 that expires on 10/04/2027. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden resident. LPA toured facility with Marilou Intog, caregiver, including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms, one (1) bedroom occupied by staff and two and half (2 1/2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the resident’s shared bathroom was measured at 112.1 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7-day supply of nonperishable and 2 days of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced 01/13/2026. First aid kit was observed to be complete. Fire drill was last conducted on 10/25/2025. Emergency disaster plan updated 01/21/2026. Continues on LIC809C Continued from LIC809. LPA reviewed all five (5) resident records, and they were complete. LPA reviewed Five (5) staff records were reviewed; all five (5) staff were associated and has FirstAid. LPA requested the following documents to be submitted to CCLD by 01/29/202 6 . LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance Updated Facility Sketch LPA observed no deficiencies during visit. Exit interview conducted a copy of this report provided.