Pre-licensing visit·April 14, 2026

At 9:15a.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 01/14/2026 for a maximum capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden. Bedridden in bedroom #2. Hospice waiver granted for six (6) 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 one (1) fully charged fire extinguisher, located between the living room and dining room. Fire extinguishers receipt dated August 08, 2025. Emergency exit plan/sketch is posted on the living room wall along with other posting requirements. Additional emergency postings to bedrooms will be added. A tour of the physical plant inside and outside was initiated at approximately 9:45a.m., and the following was observed: 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. No perishable food currently however, a supply of nonperishable and emergency food in cabinet. There was dinnerware present to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a drawer in the kitchen and inaccessible to residents. BEDROOMS: There are five (5) bedrooms. All residents’ bedrooms are furnished with bed, chair, nightstand, dresser and required bedding and linen. Continue 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 four (4) bathrooms with grab bars and non-skid mats for residents and staff to use. Water temperature was within regulation ranging between 112.4°F – 113.0°F. LPA also observed sufficient quantity of toilet papers, soap and paper towels. COMMON AREAS: The facility maintains a comfortable temperature at 70°F. The living room has a television, recliner, couches, books, board games, magazines and art supplies. 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 closet in the hallway. All medication will be locked inaccessible to residents. The facility staff/resident files will be kept in a locked cabinet, inaccessible to residents in the office space next to living room. SMOKE DETECTORS/CARBON MONOXIDE: Two (2) were in the hallway. SMOKE DETECTORS: Additional five (5) smoke detectors were observed, located one in each bedroom. They were tested and observed to be operational at time of visit. ATTACHED GARAGE: Has additional refrigerator, water supplies, laundry supplies, and laundry area. The washer/dryer is new. Garage will be always kept 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, Noraet Neshan 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.