Pre-licensing visit·December 17, 2025

On 12/17/25 Licensing Program Analyst (LPA) Mario Leon conducted an announced prelicensing visit. LPA was met by staff one, Rowena Marantal-Carrillo - Licensee (S1) and the purpose of the visit was explained. The facility is applying for a census of six (6) residents, none (0) of which may be non-ambulatory /bedridden. There is a hospice waiver for six (6) residents in place. Currently, the facility does not have any residents receiving care. The facility consists of the following: Facility is a single-story structure, located in a residential area that contains six (6) bedrooms, three (3) bathrooms, a living room, dining room, kitchen, laundry room and the den. All six (6) bedrooms (B1-B6) have the required furniture, bed linens and each room contains a light and lamp, personal storage space and will host private residents. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. B1 and B4 have in-suite bathroom(s). Each bathroom has sturdy grab bars, non-slip mat(s) and a geriatric shower chair. There was no mold or mildew present in the bathroom(s) and water temperature was measured within title 22 regulation. Two (2) fire extinguishers are fully charged, last purchased 09/19/25. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards/debris. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxins were kept in locked cabinet. First Aid kit was available. Throughout the facility, LPA noticed dusty blinds and dirty windows. Rowena Marantal-Carillo - Licensee has agreed there will be a thorough cleaning prior to hosting a new resident. LPA cited one Technical Violation, please see LIC9102TV. Component III was presented to Rowena Marantal-Carillo. An exit interview was held with S1 and a copy of this report has been provided.