Pre-licensing visit·October 7, 2025

Licensing Program Analysts (LPA’s) Edith Conchas and LaVette Farlow conducted a second announced pre-licensing visit to the facility. LPA met with Facility 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 Administrator accompanied LPA’s on a tour of the inside and outside of the facility. The physical plant, in general, was in good repair. LPA observed two (2) indoor magnetic doors that were not in functioning condition. A chair and table were propping the doors open. The buildings and grounds are free from hazards. The indoor passageways are free of obstruction. The outdoor passageways need to be free of obstruction. LPA observed an in-ground pool at the facility, the perimeter of the pool requires a pad lock. All bedrooms are furnished with a bed, night- stand, dresser, and chair. All bedrooms have adequate lighting for resident use. LPA observed mattresses did not have required protective covers. Bathroom's toilet, and showers are in good repair and have non-skid mats. LPA observed two (2) of the communal shower have water stopper to allow the water to drain as intended and keeping it from widespread pooling. LPA observed water temperature measured at 115 and 116 degrees Fahrenheit. LPA observed food storage and preparation areas to be clean and sanitary. LPA inspected indoor kitchens freezer and refrigerator not in working condition. However observed a second one in the garage 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. The outdoor space is suitable for residents use. LPA observed two (2) fully charged fire extinguishers present in the facility with last inspection October 2nd, 2024, and August 13, 2025. 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. The following are things that need to be completed. All mattresses needs mattress covers/ pads Back yard surrounding the pool needs to be free of debris. Back yard pool needs to have a pad lock. Outdoor fan needs to be in working condition Staff files were observed and were incomplete. Review and update training, CPR/ First aid and jobs descriptions etc. Indoor refrigerator need to be in working condition. The indoor magnetic doors (2) need to be in working condition. The administrator will provide proof of correction/status prior to pre-licensing approval. Pre-licensing inspection is not complete and doesn't meet the requirement to pass the inspection. LPA will initiate a third inspection when the facility completes the necessary requirements as stated. Component III was completed on 8/29/2025. An exit interview was conducted, and a copy of this report was provided to Administrator Regina Chavez.