Pre-licensing visit·October 27, 2025

On 10/27/2025, Licensing Program Analyst (LPA) Sommer Hayes arrived announced at this facility to conduct the pre-licensing for a change of ownership and facility name change inspection visit. LPA met with Licensee/Administrator, Monalisa Silapan. Overview : Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents, up to 6 may be non-ambulatory, and 1 of 6 may be bedridden. Facility is cleared to accept/retain bedridden resident in bedroom #6. Initial Observation: Upon arrival LPA was greeted by one of the staff on duty. There were 6 residents present during this visit with 2 staff on duty. Room temperature was 72 degrees Fahrenheit. Physical Inspection : LPA toured the facility with Administrator. Areas inspected include, but not limited to, resident bedrooms, resident bathrooms, living and dining room, kitchen and outdoor areas. LPA inspected 6 resident bedrooms and were observed to be equipped with the required furniture and sufficient lighting throughout. LPA measured the hot water temperature in 2 of 4 bathrooms to be 133 degrees Fahrenheit near rooms #1 and #2. Bathroom near rooms #3 and #4 was measured at 122 degrees which does not meet Title 22 regulations of 105 to 120 degrees Fahrenheit. LPA Hayes advised Licensee/Administrator that the temperature will need to be regulated to meet this requirement. Licensee/Administrator called a plumber and the plumber will be replacing the hot water heater. LPA Hayes will return at a later date to retest water temperature. Exit doors have alarms. (Continued on 809-C) A fire extinguisher was observed in the common area and each of the hallways and were inspected. Smoke and carbon monoxide detectors were observed throughout, tested and found operable at this time. LPA observed centrally stored medications, toxins, and sharp objects were kept locked and inaccessible to residents in care. In the kitchen area, LPA observed at least 7-day nonperishable and 2-day perishable food supplies. Pantry was observed to be fully stocked with non-perishable food items. Proper storage of food items was observed. Kitchen refrigerator and freezer were maintained at regulatory temperature. Backyard stored additional refrigerator and freezer. Laundry machines were located outside, and laundry supplies were locked. Outdoor area was inspected. LPA observed patio with outdoor furniture for resident use. Ramps were observed and walkways were observed to be unobstructed. No bodies of water were observed. Gates and fences were observed to be in good repair. Shut-off valves were identified. Record Reviews: Facility Infection Control and Emergency Disaster Plan were reviewed. Review of 3 staff files (S1, S2, S3) included review of background clearance, First Aid/CPR certificate, Health Screen, Initial and Ongoing Training. Licensee will not be managing residents’ cash resources. Component III: Licensee/Administrator, Monalisa Silapan waived Component III. Component III was completed on 10/16/25 during a recent pre-licensing visit with Monalisa Silapan. Pre-Licensing is incomplete, and this facility has 1 deficiency. The following advisory was given to the Administrator/Licensee for correction: The Administrator/Licensee will replace hot water heater by 10/29/25 to avoid spikes in water temperature. Exit interview was conducted and a copy of the report was provided upon exit.