Pre-licensing visit·February 23, 2026

At 09:55 am Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit at this facility. The administrators’ identity was verified by CA photo ID. The facility has a capacity of six (6). Purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPA Smith touring the physical plant inside and outside and the following was observed: The common areas (kitchen, living room, and dining areas were appropriately furnished, and lighting was adequate. The facility has some perishable and non-perishable food supply with emergency supply /water kitchen pantry. Appliances in the kitchen appeared to be functional. The living room has a television and comfortable furniture. Games and activities for residents are stored on the console table. There is one (1) fire extinguisher: attached to living room wall and was observed to be fully charged. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at time of visit. Emergency exit plan/sketch is posted near the entrances and in the bedrooms with other posting requirements on dining area wall. There are two (2) bathrooms in the facility with one (1) of the bathrooms located inside a bedroom. The hot water was tested for the bathrooms and measured 109.0 and 110.7 °F. Bathrooms have trash cans, nonslip mats and functional grab bars. (cont from 809C) The sharps are stored and locked in kitchen pantry. The medications and first aid are locked in stand-alone cabinet near dining room table and medication refrigerator. Laundry room is in detached room near patio. The laundry appliances observed to be in good repair. Linens are stored in hall closet next to main bathroom. Staff and residents’ files stored in stand-alone cabinet in living room. There is no body of water at the facility. Backyard has a pergola with table, sufficient seating and is in good repair. Detached garage is not part of the facility. The following were discussed during the visit: Removal of bricks around front of property/side gate and crawl space nail Purchase additional dresser Purchase cover for pergola Add/replace door threshold transitional strip Wipe down all appliances At the time of this visit the physical plant is meeting Title 22 requirements. Component III presentation completed at approximately 11:07 a.m. and administrator acknowledged understanding. Copy of this report will be forwarded to the CAB specialist. Exit interview was conducted and a copy of report was issued.