Pre-licensing visit·February 12, 2026

Licensing Program Analyst (LPA) Mayra Cota conducted a pre-licensing inspection today. LPA met with Jacqueline Bretz, Administrator, and the reason for the visit was explained. LPA inspected the prospective facility using the Compliance and Regulatory Enforcement (CARE) tool and completed the Component III portion of the pre-licensing process during today’s visit. The facility was approved by the Fire Department for a total capacity of (4) residents, age range 60 and over, of which (3) may be non-ambulatory in rooms 1 and 3. The single-story building is in a residential area of Pomona. The facility consists of the following: Living room/dining area, kitchen/secondary dining area, breakfast nook, family room, (1) staff room, (3) resident bedrooms, (3) full bathrooms, attached garage/laundry area, front and backyard. The following was observed during today's inspection: The building and grounds are free of hazards and both inside and outside of the facility are clean and in good repair. No pools or other bodies of water were observed. Furniture throughout the facility is in good repair and sufficient seating is available for prospective residents. The facility has a fire extinguisher in the kitchen, and it was observed charged and operable. Two carbon monoxide detectors were tested and were working properly. Facility is also equipped with interconnected, combination smoke detectors which were also tested and working properly. ***Continues on LIC 809-C Medication will be centrally stored in a locked cabinet in the kitchen. Facility telephone was tested and services are running. First-Aid kit and manual are readily available for use and kit was observed to have the required tools. The kitchen was inspected and kitchen appliances were observed to be working properly. Cleaning items will be kept locked in a cabinet in the garage and inaccessible to residents. Knives/sharps will also be kept locked in a kitchen cabinet. Three (3) resident bedrooms were inspected and have the required furniture and bedding. Hallways and bedrooms have appropriate lighting. The (3) bathrooms were inspected and observed clean, sanitary and stocked with personal hygiene items. Extra towels, bedding and hygiene products are kept in a hallway closet. Water temperature was tested in all (3) bathrooms and measured within the required 105 - 120 degrees F range. The front and backyard are kept clean, and passageways, exits and ramps are free of debris and obstruction. A shaded area was observed in the back yard and patio furniture is kept in good repair. Garage was observed clean and laundry appliances are operational and in good repair. Facility has a current Infection Control and Emergency Disaster Plan in place. Also observed posted: Visitation Rights, Personal Rights, Activity Calendar, "Let- Us-No (PUB 475) poster and Facility Sketch/emergency evacuation route. Per the Administrator, staff and resident records will be maintained at the facility. Pre-licensing is complete and there are no deficiencies. Exit interview was held and a copy of this report was provided to Jaqueline Bretz, Administrator.