Pre-licensing visit·February 13, 2026

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with Licensee Angela Fernando and Administrator Chita Beltara. A Change in Ownership (CHOW) Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on October 03,2025. A fire clearance was approved on December 2, 2025 for six (6) non ambulatory residents for a total capacity of six. Hospice waiver has been approved for six (6) residents. A tour of the physical plant was initiated at approximately 11:10 am and the following was observed: The facility is a one story building with four (4) bedrooms and two (2) bathrooms. KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). Knives were observed locked in a kitchen drawer. Medications are also locked in one of the kitchen cabinets. LPA observed the fire extinguisher that was serviced on 10/06/25. The fire extinguisher is located in the kitchen hallway. BEDROOMS: There are three(3) bedrooms designated for residents use. All three (3) bedrooms are designated for shared use. One (1) room is designated for staff use. All bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. BATHROOMS: The facility has two (2) bathrooms for the resident's use. Both bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 109.4 and 110.7 degrees (Continue on 809 C) COMMON AREAS: These included the living room and dining room. The living room was equipped with furniture, a television, tables and chairs. The dining area has a large dining room table to accommodate six (6). There were no visible immediate hazards. LAUNDRY ROOM: The washer and dryer observed to be in good repairs. Laundry room door is kept locked. Toxins and other detergents are also locked and inaccessible to residents. GARAGE: garage is used as extra storage for non-perishable and emergency food supplies and water. There is another refrigerator in the garage for additional perishable food items. Resident Files : LPA conducted a file review of random resident records to ensure compliance of licensing forms. Resident files are kept locked in the living room cabinets. Staff Files : Staff files are also kept in a locked cabinet in the living room cabinet. SURROUNDING GROUNDS: All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient yard space. LPA observed nonfunctional spa that is fenced all around it's parameters. The fence was at least five foot high with a gate, that is also five foot high. Gate was observed locked, making it inaccessible to residents to enter. The gates at both sides of the home were checked to ensure no locks were installed, and that exits and passageways were clear for emergency evacuation. Temperature: Facility maintains a comfortable temperature of 75 degrees Fahrenheit In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.