Follow-up on corrections·February 4, 2026

On February 4, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility in conjunction with the complaint visit for complaint control 22-AS-20260126155937. Administrator (AD) Eleazar Cuyson was notified via telephone and later arrived to assist with the inspection. On today's visit, the facility has a census of three residents, however, there was only one resident physically present during the visit. LPA observed two care giving staff present. LPA observed the resident to be in clean clothes. LPA, accompanied by a caregiver staff, conducted a tour of the physical plant. LPA inspected the five resident bedrooms and observed them to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed the lights in each of the resident's bedroom to be operational. LPA inspected the three bathrooms located in the facility, two of which are dedicated for resident use. LPA observed bathrooms to be clean. Bathrooms were equipped with grab bars and non-skid floor mats. LPA observed the facility has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. LPA observed the six burner gas stove lights unassisted. LPA observed the facility has a three day emergency food and water supply stored in the kitchen pantry. LPA observed the remaining utilities, such as the electricity, gas, and internet, to be operational during the visit. LPA additionally conducted interviews with three staff and the one resident present during the visit. Three out of the three staff interviewed confirmed that they are up to date on their salary and have been paid on time. CONTINUED ON LIC809-C At time of LPA's arrival, at 12:45 PM, the facility was experiencing a water shut off. Licensee Allen Medina and Maricel Nepomuceno were made aware of the situation via telephone. Licensee Allen Medina and Maricel Nepomuceno stated that the water had been shut off due to the facility having an outstanding balance with their water bill. Care giving staff on duty informed LPA that water was shut off at approximately 12:45 PM. Licensee Allen Medina and Maricel Nepomuceno were unable to restore the water during the visit. As a result, the resident, with their consent and the consent of their Responsible Party, was temporarily relocated to a different licensed facility, due to the water being shut off. LPA reviewed the files for the three residents of the facility. LPA observed that the Admission Agreement on file for Resident #1 (R1) was not signed by a facility representative. LPA observed that there was no Pre-Admission Appraisal on file for R1. LPA observed that there was no Reappraisal on file for R1 and the Reappraisal on file for Resident #2 (R2) was outdated. LPA also observed that there were no functional capability assessments on file for the three residents in of the facility. LPA additionally observed that one care giving staff present during the visit, Staff #4 (S4) was not background cleared. Based on the observations made during today's visit, deficiencies are being cited on the attached LIC809-D pages. Civil penalties will also be assessed during today's visit. An exit interview was conducted with Administrator Eleazar Cuyson. A copy of the report and Appeal Rights were provided.