Pre-licensing visit·July 10, 2025

At approximately 1:30 PM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a pre-licensing continuation inspection and was greeted by staff. David Cervantes Vibat, Applicant/Licensee was contacted via telephone and stated he is unable to make it to the facility today but gave permission to complete the visit with Gerry Ofiaza, Designated Responsible Party (DRP). This pre-licensing inspection is being conducted for a change of ownership of a Residential Care Facility for the Elderly (RCFE). Fire Clearance has been approved for 6 ambulatory residents. Facility has a dementia care plan and a Hospice waiver for two (2). At approximately 2:00 PM, LPA inspected a locked shed in the backyard which contains personal items, tools, chemicals, holiday decor, and paper and hygiene products. All other areas of concern during the initial pre licensing inspection conducted on 05/21/2025 have since been resolved. Applicant Licensee owns another care facility and is aware of the current regulations and reporting requirements; Component III orientation waived. The pre-licensing evaluation has been completed. License will be granted upon completion of a final review and approval from the Licensing Program Manager. This report was reviewed with DRP and a copy was provided. Exit interview conducted with DRP, whose signature on this document confirms receipt .