Pre-licensing visit·May 6, 2026

At 9:00a.m., Licensing Program Analyst (LPA), Antonia Alvizar-Ettima conducted an announced pre-licensing visit to the above facility and met with Administrator and Assistant Administrator. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL). Fire Clearance was approved on 01/26/2026 for a maximum capacity of six (6) non-ambulatory residents age range 60 and over. The purpose of today’s visit is to inspect the facility to ensure that the physical plant is in compliance with rules and regulations of California Code of Regulations, Title 22, Division 6, Chapter 8. The facility is a single-story building in a residential community. The facility has two (2) fully charged fire extinguisher, located between the kitchen and living room. Fire extinguishers receipt dated October 22, 2025. Emergency exit plan/sketch is posted on the office space along with other posting requirements. Emergency exit plan/sketch is also posted in bedroom and throughout the facility. Today's site visit consisted of LPA Alvizar-Ettima touring the physical plant inside and outside at approximately 9:30a.m., and observed the following: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, dishwasher, sink, stove and microwave. The kitchen food preparation was observed to be sanitary. There were at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. There was dinnerware present to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in kitchen drawer and inaccessible to residents. BEDROOMS: There are four (4) bedrooms. All bedrooms are furnished with bed, chair, night stand, dresser and required bedding and linen. Cont. on LIC809-C Cont. from LIC 809 The bedrooms have sufficient closet space and have sufficient lighting. BATHROOMS: LPA inspected the bathrooms they are clean and in excellent condition. LPA observed three (3) bathrooms with grab bars and non-skid mats for residents and staff to use. Hot water temperature measured 113.4 degrees Fahrenheit. LPA also observed sufficient quantity of toilet paper, soap and paper towels. All trash cans had fitted lids to protect them from cross contamination. LAUNDRY AREA: The laundry area is located in the hallway with a locked door when not in used by staff. The washer/dryer appeared to be new. Laundry supplies are kept inaccessible when not in use. COMMON AREAS: The facility maintains a comfortable temperature at 68°F. The living room has a television, couch, recliners, books, board games, magazines and art supplies. In the living room there is a fireplace that is properly covered with metal cover and will not be used. The dining area has a table with six (6) chairs that were clean and properly furnished. MEDICATION: The medication and first aid kit will be kept in locked cart in the office area. All medication will be locked inaccessible to residents. The resident facility files will be kept in a locked cabinet, inaccessible to residents in the office space next to living room. SMOKE DETECTORS/CARBON MONOXIDE: There are six (6) Smoke Detectors/Carbon Monoxide hardwired, Hydraulic Sprinkler system in each bedroom and throughout the facility. DETACHED GARAGE: Has additional refrigerator and office space. Cleaning supplies, non-perishable food and other items are being stored in garage cabinets. Garage will be always kept locked and inaccessible to residents. SURROUNDING GROUNDS: The facility grounds were well landscaped and enclosed. The passageways and entrance to the facility were clear of obstruction. Entry and exit doors have a functional auditory alert when the doors open at the time of visit. LPA observed appropriate outdoor furniture and sufficient shaded yard area for residents. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. The facility has no bodies of water. Component III: Administrator, Imran Syed completed Component III during today’s pre-licensing visit and acknowledged understanding. 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 and a copy of this report was provided to Administrator.