Pre-licensing visit·November 17, 2025

On 11/17/25, at 08:55am, Licensing Program Analyst (LPA) Gina Saucedo conducted an announced Pre-licensing visit. LPA met with Administrator/Licensee, Camila Gutierrez and Andrew Novich. An application was submitted to Community Care Licensing Division-CCLD on 04/07/2025, Initial license for a Residential Care Facility for the Elderly (RCFE), 60 years and older. The requested capacity is for five (5) non-ambulatory and one (1) bedridden, total of up to six (6) residents and fire clearance was approved on 08/20/2025-Room number two (2) is for bedridden. Structure : The facility is a single-story building with six (6) bedrooms and three and 1/2 half (31/2) bathrooms. Entrance : There is only one (1) entrance being utilized. There is an Emergency Disaster Plan, Personal Rights, Theft and Loss Policy against the wall, Yes sign. Toxins, cleaning solutions, and laundry detergents are kept locked under the sink in the kitchen. Some other toxins/cleaning solutions will also be in the pantry where there is a washer and dryer. Living/Dining area : The living room is neat, clean, and organized with sufficient seating for both residents and staff. The dining area is also neat, clean, and organized. Both rooms are properly furnished and in good repair. The facility maintains a comfortable temperature of sixty-eight (68) degrees. No firearms observed or will be maintained on the premises. There is a fireplace in the living/dining room area which is located in the Activities area. LIC809C-continued Kitchen : Sufficient supplies of dishes, cups, and silverware located within the kitchen cabinets and drawers. Sharps are stored on the left side of the kitchen locked in one (1) of the cabinets. The kitchen appliances are working and are in good repair. First-aid kit observed as well. There is a working telephone on the premises. Emergency : There are several fire extinguishers located throughout the house. Medications : Medication will be stored by the kitchen area in a one (1) of the pantry areas against the wall. Bedrooms : The bedrooms are properly furnished with bed, nightstand, applicable lightening, and seating. Window coverings are in good repair, not broken or damaged. Bathroom : The bathrooms are in proper condition and will be equipped with sufficient personal hygiene for each client. Towels and washcloths will not be shared, grab-bars. Hallways : Hallway is properly lighted. Extra linens/covers observed in storage cabinet within the passageway. Staff room : There is a designated staff room on the side of the facility next to the activities room. Water Temperature : The water temperatures were measured in the bathrooms at 105 and 117 Fahrenheit and are within regulations. LIC809C-continued S moke detectors : Dual interconnected smoke detectors and carbon monoxide observed to be working properly and were tested. Garage : There is a garage. Outside : The outside furnished with sufficient seating. A shaded area for residents/staff was observed as well. Pool : There is a pool in the backyard that is gated and locked. Cameras : There are cameras in the common area of the facility. Administration : The facility had submitted an Emergency and Disaster Plan For Residential Care Facilities For The Elderly and Infection plan. The Component III Orientation RCFE was shown/reviewed with the Administrator/Licensee. Facility is in compliance with Title 22 Regulations at this time. 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. Exit interview conducted and copy of this report issued to the administrator.