Pre-licensing visit·April 30, 2026

Licensing Program Analyst (LPA) Tena Herrera conducted an announced pre-licensing visit and met with Administrator Rowena Carrillo and Licensee Jon Gardea. The purpose of todays visit is to conduct a Pre-Licensing Inspection / Component III visit. The facility has an approved fire clearance to be licensed to serve 1 Bedridden and 5 Non-Ambulatory Residents ages 60 and above. The facility is a single story home located in Downey, CA, a tour of the facility includes: 4 bedrooms (2 of which are shared bedrooms), 2 bathrooms, dining room, living room, kitchen, front yard/back yard, detached garage with laundry area. There is an ADU detached from the facility where the licensee intends to live, residents will not have access to this ADU. The physical plant was toured and the following was observed/inspected: · Bedrooms are equipped with bed, night-stand, chair, sufficient lighting, closet and drawer space. · All beds had the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Mattresses and bedsprings are in good repair. · Bedrooms are large enough to allow for easy passage between and comfortable for usage of beds and other required items of furniture. · Sufficient supply of personal hygiene items and linens are available and are stored in storage cabinet. · Laundry machine (wash/dryer) observed and is located in the detached garage. · The 2 bathrooms have a working toilet, wash basin, shower, the required grab bars and non-slip mats. · Smoke Detectors and Carbon monoxide detectors were observed and operable. · Fire extinguishers observed and fully charged. (Continued on LIC809-C) · Cleaning solutions and sharps are securely locked in kitchen. · Kitchen cabinets, refrigerator/freezer , oven, microwave, dishwasher are in working condition, clean and sanitary. Sufficient food supply was observed along with emergency food supply. · Sufficient dishes, cups, and silverware are readily available and in good repair · Dining area is fully furnished for 6 individuals. · There is a designated space for Medications that is locked. · Client and Staff files will be stored in a locked cabinet. · First Aid Kit and manual was observed. · Building and grounds are free from hazards. Window screens are in good condition. · There is a shaded area provided in the backyard. · Hot water temperature measured and was within the required range of 105-120 degrees F. · The residence is equipped with central air and heating, temperature remains at a comfortable temperature. · Facility phone line was tested and is operable, facility number: 562-441-8446. · Licensee reports no guns, weapons or ammunition will be stored in the facility. · Emergency Disaster Plan was observed and will be posted prior to admitting residents · Both Administrator Rowena and Licensee Jon maintain a valid administrator certificate. · The facility does not have the required liability insurance yet, however, Administrator confirmed they will have insurance prior to admitting any residents. · Resident Rights, Complaint, and Ombudsman Posters were observed posted in the living room area. · Facility has a variety of activities and games stored in a cabinet *there is work being done behind the ADU, licensee is having a private patio area added, licensee confirmed that area that will be inaccessible to residents and work will be completed by 5/8/26, residents will not be admitted until after work is complete* LPA is also clarifying with the fire department and CAB regarding which room is approved for bedridden. Component III was completed during todays visit and reviewed by Licensee and Administrator. An exit interview was conducted, and a copy of this report was provided. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.