Pre-licensing visit·November 19, 2025

At 9:30AM Licensing Program Analyst (LPA), Antonia Alvizar-Ettima conducted an announced Pre-Licensing visit to the above facility and met with Chief Executive Officer (CEO), Crystal Vargas. Fire Clearance was approved on 10/09/2025 for a maximum capacity of six (6) residents non-ambulatory, of which one (1) may be bedridden only in room #1 or room #4. Waiver/granted for hospice care for six (6) residents. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. The facility is a single-story building in a residential community. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave and sink. LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. Fully charged fire extinguishers located above the sink with purchase dated 10/08/2025. Medication will be kept in a basket with resident’s name; first aid kit has all required supplies and locked in a kitchen cabinet. LAUNDRY ROOM: The laundry room is located next to the office space with a locked door. The washer/dryer appeared to be in excellent condition. Laundry supplies are kept in laundry room inaccessible to residents at all times. BEDROOMS: There are four (4) bedrooms designated for residents’ use. All bedrooms are furnished with beds and dressers and required bedding and linen. The bedrooms have sufficient closet space and have Continue on LIC809-C Cont. from 809 sufficient lighting. Auditory alarms were tested and observed to be operational. BATHROOMS: LPA observed all bathrooms are clean and in excellent repair. Properly supplied with toilet paper, soap and paper towels. LPA observed appropriate grab bar and had non-skid mat. Water temperature was within regulation. COMMON AREAS: The facility maintains a comfortable temperature at 73°F. The living room and dining area appeared clean and were properly furnished. No obstructions or tripping hazards throughout the facility. OFFICE SPACE: On a bookshelf there were puzzles, coloring books, crayons, and board games. Facility staff/resident files will be kept in a locked cabinet. SMOKE DETECTORS/CARBON MONOXIDE. Dual smoke detectors and carbon monoxide were located in the bedrooms and throughout the facility. They were tested and observed to be operational. SURROUNDING GROUNDS: The entrance to the home is gated. In the back of the facility has sufficient yard space. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The backyard is fenced. The detached garage is kept locked and currently being used for storage. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. There are no bodies of water. Component III: Chief Executive Officer (CEO), Crystal Vargas completed Component III during today’s Pre-Licensing visit. Based on inspection and observation, the physical plant is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and the applicant will be notified by the CAB Analyst when your license has been approved. Exit interview was conducted a copy of this report was provided to CEO, Crystal Vargas.