Pre-licensing visit·March 2, 2026

Licensing Program Analyst (LPA) Ruth Martinez conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA arrived at the facility was greeted and granted entry. LPA met with Francisco Escobedo, Natasha Shoga and Cynthia Shoga, applicants and explained the visit. A change of ownership application to operate an Adult Residential Facility for the Elderly, age 60 years and over, for (6) capacity, (1) ambulatory, (4) non-ambulatory, and (1) bedridden resident was submitted to CCL on 10/06/25. Structure: The facility is a one story house with an attached garage with 5 resident bedrooms, 3 full bathrooms, a living rooms, a dining room, and a kitchen. The residents’ bedrooms are spacious and will easily accommodate the resident’s furnishings. There is a large back yard and exit walkways on each side of the house with seating for the residents in the front and backyard. Air/Heating: Central air/heating system installed with a central panel to control entire house. Bedrooms Residents: Bedrooms will accommodate 6 residents with 4 private rooms and 1 shared room accommodating two residents. Bedroom 5 approved for one bedridden resident in approved bedroom #2, bedroom #3, 4, & 5 approved for non-ambulatory residents, and bedroom 1 approved for one ambulatory resident. Bedrooms #4 & 5 have a full bathroom. Bedrooms Staff: There is no live in staff. Bathrooms: Facility has three full bathrooms. All bathrooms have a working toilet, wash basin, walk in shower. Linens & Hygiene Supplies: Adequate supply of linen in closet storage located in laundry Continue on LIC809-C unit. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food serve for one week. Food Service: Adequate supply of 7-day non-perishable and 2-day perishables are stored in the kitchen with non-perishables stored in garage. There is an additional refrigerator and freezer in the garage. Smoke Detectors: Smoke detectors and carbon monoxide alert systems are hardwired, were tested, and found operational. 1 fire extinguishers mounted in the kitchen charged and dated 4/15/25. Appliances: Electric 4 burner stove, single oven, 2 refrigerators (kitchen and garage), freezer (garage), microwave, dishwasher, washer, and dryer are clean and noted to be operational. Toxins: All and any toxic chemicals, cleaning solutions and disinfectants are inaccessible to residents are stored and locked underneath kitchen sink and in the garage. Water Temperature: Tested and recorded maintained at a comfortable temperature and the water temperature measures 114.8 Fahrenheit degrees in facility bathrooms. Medications, First-Aid Kit & Book: Medication, first aid kit, first aid manual are stored in a locked cabinet in dining room next to exit door. Resident & Staff Files : Records will be kept locked in a cabinet located in the living room. Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the residents’ use, commensurate with the plan of operation. Fire clearance: Was approved on 10/28/25. Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within substantial compliance. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB in Sacramento for final review prior to license being issued. Exit interview was conducted and a copy of this report was left with the applicant.