Post-licensing visit·January 14, 2026

On 01/14/26 Licensing Program Analyst (LPA) Mario Leon conducted a required annual visit at the facility. Upon entrance, LPA was met by staff one, Renette De La Cruz - Licensee (S1) and the purpose of the visit was explained. The facility is a single-story home located in a residential neighborhood, which consists of the following: four (4) bedrooms, two “half-bath” (2) bathrooms, one (1) kitchen, (1) dining room, one (1) living room, with an attached garage, and is located within a residential neighborhood. Facility maintains all required posting throughout the facility. LPA reviewed both resident files and found that they contained all required documents. LPA reviewed two (2) staff files and found they contained the required documents, and trainings. LPA reviewed their Liability Insurance. LPA reviewed the training logs for staff . The facility has a current census of three (3) residents (R1-R3). S1 and LPA toured the facility, inside and out. MEDICATIONS: There is a locked centralized storage area for client medications. PHYSICAL PLANT: Facility is clean, sanitary, and in good repair. Protective devices are in place to include fire prevention and mitigation and all are operational. Indoor and outdoor passageways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions. There is one (1) pool, located in the back yard with a locked 5ft-high fence surrounding the water, making the water inaccessible to residents in care. There are locked storage areas for poisons, pool chemicals and sharps. All window screens are clean and in good repair. Facility maintains a comfortable temperature at 77.5 degrees F. The facility has central air. Inclines, ramps, open porches, and areas of potential hazard are well-lit and adequately equipped for elderly residents. Nine (9) smoke detectors are hard wired and operate properly. Two (2) Carbon monoxide detectors operate properly. S1 shut off the facility power source to indicate emergency lighting as operational. Report continues, please see LIC809-C. All kitchen, food storage, and preparation areas are clean and food items are labeled by date of purchase by S1. RECORDS There is confidential storage of personnel records at the facility. There is confidential storage of client records at the facility. Both have been observed as locked. ADMINISTRATION The emergency exiting plan and emergency phone numbers are posted. Client Personal Rights are posted. Facility Visiting Policy is posted within the Admissions Agreement and nearby other mandated reporting poster(s). Licensing Complaint Poster is posted. There is space available for resident council meetings and resident council postings. ACTIVITIES There is a shared outdoor activity space with shaded areas and are furnished for outdoor use. There is at least one common room available to clients for visitors. There are activity supplies which include newspapers, magazines, and a variety of reading material as well as a variety of different types of “stress ball” present. MISCELLANEOUS There are first-aid supplies which include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual. There is space and equipment for laundry. There is a space for clean linen storage and a separate space for soiled linen. There is an operating telephone available to clients. Emergency lighting and supplies are present, which includes flashlights with batteries. Vehicles used to transport clients are in safe operating condition. During today's inspection, LPA observed four (4) staff present. Upon review of Personnel Summary, there are only two (2) staff associated. When asked about the additional staff, S1 informed LPA that the two (2) additional staff's association has been mailed to Sacramento during the prior week. LPA did not cite, as the two (2) staff's paperwork are also being held at the facility. LPA created a technical violation, please see LIC9102TV. There have been zero (0) deficiencies cited during today's visit. An exit interview was held with Renette De La Cruz and a copy of this report has been provided.