Pre-licensing visit·April 14, 2026

On April 14, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived announced for the purpose of conducting the Pre-Licensing visit for an Initial Application. LPA conducted the visit with Applicant/Administrator Kathrina Buller and Administrator Alyssa Gutierrez. The initial application to operate a Residential Care Facility for the Elderly (RCFE) was received by the Department of Social Services on June 25, 2025, for age range 60 and older, with Fire Clearance approved for six (6) non-ambulatory residents and one(1) Bedridden resident in Room #1 Only, with a Hospice waiver granted for six (6). LPA toured the facility's indoor and outdoor physical plant with Applicant Kathrina Buller. The following were observed: Structure: The facility is a single-story property in a residential neighborhood comprised of four resident bedrooms, two full bathrooms, and an attached two car garage. LPA observed all common areas which include the living room, dining area, and kitchen. Telephone Number: The facility currently has a land line with the number (657)231-9389. CONTINUE TO LIC809-C .... Emergency Phone Numbers/Exit Plan: Posted in the entry way. Postings: The See Something, Say Something (PUB475) was posted and all other required posting were available in the entry way. Food Service and Menu: Supply of seven-day non-perishable and two-day perishables were observed in the kitchen. The emergency food/water supply was available. LPA observed the Food Menu posted on the refrigerator. Smoke and Carbon Monoxide Detectors: The smoke detectors and carbon monoxide alert systems were tested and found operational. Fire Extinguishers: The fire extinguisher was mounted, fully charged, and last serviced on October 6, 2025. Fire Clearance: Approved on August 12, 2025, for five (5) non-ambulatory residents and 1 Bedridden resident. Signal System: The facility has a signal system. Bedrooms: The resident bedrooms had all required components, are spacious, and easily accommodate the residents’ furnishings. All rooms and closets contained space for residents’ personal items and belongings. CONTINUE TO LIC809-C .... Bathrooms: Bathrooms were clean and operational. Bathroom #1 has two entry doors, one from inside the residents’ bedroom and a second one leading into the hallway. Bathroom #1 has a grab bar secured in the shower, however, there is not a grab bar near the toilet. Water Temperature: The water temperature in the two bathrooms measured between 116.2 and 119.3 degrees Fahrenheit. Linens and Hygiene Supplies: Clean linens and hygiene supplies for resident use were fully stocked. Appliances : Stove burners, microwaves, refrigerator, freezer, and washer/dryer were inspected and operating. Resident and Staff Files: Resident and staff records were reviewed and will be maintained on site. Medication: Medication is secured in a closet near the front entrance. Reading Material, Games, Equipment, & Materials: Games and activities were available. Sharps and Toxins: Sharps are secured in a drawer in the kitchen and inaccessible. Cleaning supplies and toxins were observed locked. First Aid Kit & Manual: The First Aid Kit was checked and has all the required elements. CONTINUE TO LIC809-C .. Liability Insurance: Facility does not have liability insurance for the new facility. A proposal for liability insurance protection was requested. The following items requiring correction: · Install grab bar near the toilet in Hallway/Bathroom Bedroom#1 · Provide mattress pads and full bedding on all resident beds · Ensure all emergency supplies listed on the Emergency Disaster Plan (LIC610E) are present and available · Amend the LIC610E reflecting the type of residents served · Repair screens on two sliding doors · Submit proof of liability insurance policy Based on today’s observation, the facility is not ready for licensure. A subsequent visit will be conducted to review the corrections on May 5, 2026 and Applicant will contact the department if an extension is needed. An exit interview was conducted with Applicant/Administrator Kathrina Buller and Administrator Alyssa Gutierrez, and a copy of this report was provided at the end of the visit.