Pre-licensing visit·May 12, 2026

At 9:45a.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/CEO. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL). Fire Clearance was approved on 01/27/2026 for a maximum capacity of six (6) ambulatory residents, of which five (5) may be non-ambulatory and one (1) may be bedridden. Room #1 approved for bedridden. Waiver/granted hospice care 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 kitchen and dining room. Fire extinguishers receipt dated December 02, 2025. Emergency exit plan/sketch is posted on the living room wall along with other posting requirements. Additional emergency exit plan/sketch are posted in each bedroom. A tour of the physical plant inside an outside was initiated at approximately 10:00a.m., and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, 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 kitchen cabinets. 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. Cont. on LIC809-C Cont. from LIC 809 BEDROOMS: There are five (5) bedrooms. All residents’ bedrooms are furnished with bed, chair, nightstand, dresser and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. BATHROOMS: LPA inspected the bathrooms they are clean and in excellent condition. LPA observed two (2) bathrooms; one (1) full and a half (1/2) with grab bars and non-skid mats for residents and staff to use. Water temperature was within regulation ranging between 109.4°F – 110.0°F. LPA also observed sufficient quantity of toilet papers, soap and paper towels. COMMON AREAS: The facility maintains a comfortable temperature at 72°F. The living room has a television, couches, books, board games, magazines, art supplies and purified water dispenser. 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 stored in a locked closet inaccessible to residents. Staff and residents’ files will be maintained in a locked closet inaccessible to residents in the hallway. Extra laundry detergents and cleaning supplies were observed stored in a locked closet in hallway inaccessible to residents. LAUNDRY AREA: The laundry area is located in the hallway; the washer and dryer were in working condition at the time of the visit. Laundry detergents were observed stored in a locked laundry area inaccessible to residents. SMOKE DETECTORS/CARBON MONOXIDE: Two (2) were in the hallway and dining area. 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. SURROUNDING GROUNDS: The facility grounds were well maintained 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 garage or body of water. Component III: Administrator, Liana Pitinyan 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.