Pre-licensing visit·November 12, 2025

Licensing Program Analyst (LPA) Kimberly Lyman made an announced visit to conduct a pre-licensing inspection. LPA identified herself and discussed the purpose of the visit with Administrator Jeseca Aznar. An initial application to operate a Residential Care Facility for the Elderly was received by CCL on 07/16/2025 for a capacity of six non-ambulatory clients of which one may be bedridden. Jeseca Aznar has an administrator certificate expiring on 05/10/2026. Upon entry, facility appears clean, safe and sanitary. LPA Lyman along with Licensee/ Administrator Aznar toured the facility at 8:15 AM and observed the following: Structure: Facility is a one story, 5 bedroom, 2 bathroom house with an attached garage and a tan exterior. Living Room/ Dining Room : Adequate seating is available in the dining room and living room. Bedrooms Clients: Rooms will be double and single occupancy. All rooms are equipped with appropriate lighting, chair, night stand and ample closet space. Bathrooms: All client bathrooms have a working toilet/ wash basin as well as grab bars and non-skid surface in the shower. Facility has sanitizer/ soap and paper towels in the restrooms. Linens & Hygiene Supplies: Facility has ample bedding and towels for clients in care. Emergency Phone Numbers and Exit Plan: Posted in entrance of facility. Food Service: Facility does not have 2 day perishables and 7 day non-perishables as there are no clients present. Facility to obtain items once licensed. Smoke Detectors: Smoke detectors/ carbon monoxide detectors are connected and were tested operational. Fire extinguisher is mounted and charged. Appliances: Stove, oven, refrigerator, microwave, washer, and dryer are clean and operational. Toxins / Sharps : Facility has secured areas for toxins and sharps in the garage and kitchen. Water Temperature: Tested and recorded between 107.9 and 108.3 degrees F. in facility bathrooms. Emergency Supplies: LPA observed ample emergency food and water in the facility. Medications, First-Aid Kit & Book: First aid kit observed contained all required items including a first aid guide. CONTINUED ON LIC 809C DATED 11/12/2025 Medication is stored and locked in a cabinet in the dining room. Facility to use a medication administration record. Client & Staff File: Records are stored in a secured file cabinet in the dining room . Reading Material, Games, and Equipment: LPA observed an activity schedule with activities such as exercise and arts and crafts. LPA observed games, toys and books in the facility as well. Backyard : LPA observed a large backyard with shaded areas for relaxing and visitation. Fire Clearance: Approved for six non-ambulatory of which one may be bedridden on 07/23/2025. Component III conducted during the visit. Facility is ready to be licensed. Exit interview conducted and a copy of this report was left at the facility.