Pre-licensing visit·October 10, 2025

On 10/10/2025 Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced pre-licensing visit to this facility and met with the Applicant, Jeanette Mendoza. This is a new application. A fire clearance dated 12/20/2024 was received for six (6) non-ambulatory residents of which Bedrooms 1 and 2 for two non-ambulatory residents, Bedrooms 3 and 4 for one non-ambulatory residents. Bedroom 5 is designated for staff use only. The facility phone number 661-268-4870. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. Component III was conducted with the applicant from 9:30 am 10:40 am. LPA and the Licensee toured the physical plant inside and outside from 10:40 am until 11:15 am. LPA Spaeth observed the following: Living Room – the living room contained individual recliners for the comfort of the residents. Kitchen - The kitchen contained a dining room table and chairs. The knives were locked in a drawer and the cleaning solutions were locked in a kitchen cabinet. The facility contained a two-day supply of perishable food and a seven day supply of non-perishable food. A fire extinguisher is located in the kitchen area. The resident files, first aid kit and medications will be locked in a file cabinet within the kitchen area. Continued on 809-C Laundry Room – The room was locked and contained a washer and dryer and laundry detergent. Backyard - The backyard has a shaded area with a table and chairs. The gate leading from the back yard to the front yard was not locked. Garage – the garage was locked. Water Temperature - The water temperature was tested at 11:00 am and was 109 degrees F. Bathrooms - The bathrooms contained hand soap, slip resistant strips, paper towels, grab bars and a trash can. Bedrooms – The bedrooms contained bed, linens, night stand, chest of drawers, a chair, and a closet. Staff Room - The staff room is located near the front door of the facility. Hallway Closet - The hallway closet contained linens. Egress - All exits doors contain the delayed egress alarms and were all operable. The smoke/carbon monoxide detectors were tested at 11:10 am and were operable. The facility was clean and appears to be in good repair. This report will be forwarded to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved.