Pre-licensing visit·August 29, 2025

Licensing Program Analysts (LPA’s) Edith Conchas and Paola Guerrero conducted an announced pre-licensing visit to the facility. LPA met with Facil ity License Maricel Nepomuceno and Administrator Regina Chavez. The pending application is for a Residential Care Facility for Elderly (RCFE). The capacity is six (6). The census is zero. The Licensee and Administrator accompanied LPA’s on a tour of the inside and outside of the facility. The physical plant, in general, was in good repair. The buildings and grounds are free from hazards. The indoor and outdoor passageways are free of obstruction. LPA observed an in-ground pool at the facility, the perimeter of the pool was gated and locked. All bedrooms are furnished with a bed, nightstand, dresser, and chair. All bedrooms have adequate lighting for resident use. Bathroom's toilet, an tubs are in good repair and have non-skid mats. LPA observed one (1) of the communal shower water failed to drain as intended and instead migrated toward the main bathroom floor, causing widespread pooling. LPA observed food storage and preparation areas to be clean and sanitary. LPA inspected facilities freezer and Refrigerator with appropriate temperatures according to Title 22 regulation.There is enough Emergency water supply and the required 72-hour emergency food supply for residents and staffs available at the facility. All appliances are clean and operating. The outdoor space is suitable for residents use. LPA observed two (2) fully charged fire extinguishers present in the facility. Smoke alarms and carbon monoxide are present and functional. Facility has a designated area (Med-cabinet) where medications are locked and stored. Continue LIC 809-C The facility had a designated area where staff and resident records are stored. Emergency disaster plans, personal rights, and complaint posters were posted in a common area. There is adequate seating in the common areas. Facility had a supply of activities for the residents. During review of records LPAs found plan of operation, admission agreement, along with an updated facility sketch. Pre-licensing inspection is not complete and doesn't meet the requirement to pass the inspection. LPA will initiate a second inspection when the facility completes the necessary requirements as stated. Component III was completed on this day as well. An exit interview was conducted, and a copy of this report was provided to Licensee Maricel Nepomuceno and Facility Administrator Regina Chavez.