Pre-licensing visit·December 16, 2025

Licensing Program Analyst (LPA) Evelin Rios conducted a Pre-Licensing Inspection with the licensee representative/administrator, Marta Marquez. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 02/24/2025. A fire clearance was approved on 04/04/2025 for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six (6). At entrance LPA observed required postings. At the entrance LPA observed PPE for staff and visitors and the facility will have a sign in sheet for visitors. A tour of the physical plant was initiated at approximately 9:40 a.m., and the following was observed: Bedrooms: There are six (06) total bedrooms designated for residents use. Per the Fire Inspection Safety Request (STD 850), bedroom #5 is cleared for one (1) bedridden resident. Bedrooms designated for resident use have appropriate furniture with sufficient lighting and storage space. LPA observed functional auditory alarms on all exit doors. LPA observed a fully charged fire extinguisher purchased on 03/14/2025 by bedroom #3. Kitchen: The kitchen is equipped with a refrigerator, stovetop, oven, dishwasher and microwave. The facility has a sufficient amount of two day perishable and seven day non perishable supply of food. The facility has dishware and cook ware for the capacity of the facility. Knives are kept locked in a kitchen drawer. Cleaning supplies are kept locked under the kitchen sink. Residents' medication will be locked in a kitchen cabinet. (Continue to LIC809-C) Common Areas: Furniture such as the dining table, chairs and couches were observed in good repair. Both living room and dining room have sufficient space. LPA observed a television and games in the living room. A fireplace was also observed not in use, secured with a screen. No tripping hazards observed. Bathrooms: The facility has three (3) bathrooms. Three (3) bathrooms are designated for resident use of which one (1) is located in the shared room. Bathrooms were observed to have proper fixtures, grab bars, and non-skid stickers in the showers. The hot water temperature was measured in two (2) bathrooms and read between 110.7 and 111.9 degrees Fahrenheit, within regulation. Laundry/Garage: The laundry room is accessible to residents and equipped with a washer and dryer. LPA observed detergent, and cleaning supplies are kept locked in a laundry room cabinet. The attached garage is will be kept locked. Resident/Staff Records: Resident, staff, and facility records will be stored in a locked filing cabinet in the dining room. Backyard: LPA observed a fenced in backyard with appropriate outdoor furniture. No bodies of water on the premises. Exits and passageways were clear from obstructions. The carbon monoxide detector was observed in the hallway to the bedrooms, functioning. Smoke detectors are located throughout the facility. LPA observed the administrator test the smoke detectors at 10:19 a.m., and they were functioning properly. Component III was held with Licensee representative/administrator. Pre-Licensing is complete and no deficiencies were observed. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the license has been approved. Exit interview was conducted. A copy of this report was signed and provided.