Routine inspection·February 6, 2026

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility on 2/6/2026 at 9:45 am to conduct an annual inspection. LPA met with administrator Arlyn De La Cruz and explained the purpose of the visit. 2 clients have restricted conditions, both are diabetic one has additionally O2 administration. Arlyns guest home is an RCFE for the elderly/developmentaly disabled + dementia with a capacity of 6 nonambulatory and 2 hospice and a current census of 3 nonamb, 0 hospice. Exception paperwork will be filled out for the O2 administration. Physical inspection included but was not limited to: Kitchen,bedrooms, bathrooms, common areas, storage areas, the exteriors, and the evacuation route. facility is clean, traffic areas are unobstructed and well lit. Kitchen has food storage for 2 days perishable and 7 days non perishable for 3 clients. LPA gave guidance to put "Staff" of staff foods. there is lockable storage for the medication, Per administrator, VMRC has said not to lock the cleaning matierials and knives. LPA gave guideance that knives and cleadning chemicals should be in lockable storage when outside of supervised use. Bedrooms have required furniture and furnishings, including materess encasements, there exists duplicate linens. bathrooms have functional hardware, common areas and exteriors are free of trip hazzards and furnishings are in good repair, evacuation route gate swings freely and latches closed, on one side on the building. a secondary gate does drag into the concrete. LPA gave guidance to monitor the situation. Continued on c Page. Fire extinguisher was dated 12/12/25, Smoke/Co alarm was functional, water temperature was measured at 105-120*F. Medication was checked against mars for 2 clients at random, found to be in agreement. LPA pointed out there are too many drugs for one of the clients, per administrator the excess will be destroyed and marked in the destruction record. LPA gave guidance that medication with variable dosage should not be given without a documented consultation from a licensed medical professional every time, and it would be improper for her as the licensee to make medical choices regarding the clients care, since she has a buisness interest in particular outcomes. Client files were reviewed including but not limited to: recent medical assessments, signed admission agreements, needs and servess plans, functional assessments and IPPs. documents are up to date and present. P+I was checked against balance statement for 1 clients, found to beholding cash over the balance sheet by about 50 cents. LPA gave guidance it should be tracked accurately. Staff files were reviewed including but not limited to: health screenings, initial and continued trainings, first aid training, and backround check clearances with the doj and fbi, were found to be present and up to date. LPA gave guidance that annual training topics should lean on developmentally disabled clients needs, and diabetic care. LPA gave guidance Any clients unplanned visit to the hospital/acute psychiatric should be reported to ccl within 7 days of the occurrence using the LIC 624 form. Administrator files were reviewed, including but not limited to: facility posters(ombudsman, client rights, family council, resident council, emergency/abuse services contacts, facility sketch with evacuation route, facility license, federal work rights, and administrators license()expires 11/23/25) are all in the staff room. Per administrator VMRC asked for posters to not be in the living space of the facility, LPA gave guidance that at least the ombudsman, client rights, emergency and abuse services contacts, and facility sketch with evacuation rout should be posted near the door. control of property, liability insurance, surety bond, were found to be present and up to date. administrators hiv training, infection control plan, evacuation plan, workers comp, should be emailed to the LPA. Gaurdian roster should be cleaned out at least once a year, but ideally when people come on or leave the company. noel.wolfpetersen@dss.ca.gov 3 interviews with clients, 1 interview with staff. A copy of the report was read and given to the administrator, an exit interview was conducted.