Pre-licensing visit·December 12, 2025

Licensing Program Analyst (LPA) Magda Malcore conducted an announced Pre-Licensing visit to the facility. LPA met with applicant, Addy Escabedo. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Centralized Applications Bureau. A fire clearance was granted by Apple Valley Fire department on 9/30/2025 for a total capacity of six (6) clients, 1 of which may be non-ambulatory/bedridden. The following was observed: Physical Plant (Indoor/Outdoor): The facility consist of three (3) resident bedrooms, one (1) bathroom, kitchen/dining rooms, living room, and attached garage. Indoor and outdoor passageways and inclines are free of obstructions. No swimming pools or bodies of water were observed. Outdoor activity area is enclosed with a gate. Laundry equipment, two (2) fully charged fire extinguishers, operating smoke alarms/carbon monoxide detectors, hallway night lights, first aid kit, theft/loss policy, resident personal rights and resident council postings were observed during inspection. There is a designated area were resident/staff files will be stored. There is a designated locked cabinet where sharps and cleaning supplies are stored. There is a designated locked cabinet where medications will be stored. Bedrooms: Resident bedrooms were equipped with mattresses, chairs, nightstands, bed linen and lighting. No resident bedrooms are passageways to another bedrooms. Bathroom: Resident bathroom was clean and equipped with grab rails, non-slip material in bathtub floor, operating toilets/washbasins/showers. Hot water temperature measured at 108 degrees Fahrenheit(F). Food Service: The kitchen and food preparation areas are clean and adequate number of cups, dishes, and utensils for client use. Food storage cabinets are large enough for a seven (7) day supply of non-perishable foods. Refrigerator and freezer is in good condition; there is enough storage space for at least two (2) days of perishable foods. Composition III orientation was completed during today's inspection. The applicant shall make the following corrections prior licensure. 87465 Incidental Medical and Dental Care Services - proof of a current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency is maintained at the facility. 87219 - Planned Activities Outdoor - Proof of adequate shady areas. An exit interview was conducted where this report was discussed and a copy of this report was provided to applicant Escabedo at the conclusion of the visit.