Pre-licensing visit·October 28, 2025

At 10:00am Licensing Program Analyst (LPA) Contreras arrived for a scheduled pre-licensing visit and was greeted by administrator (admin) Juan Miguel Luis Santos. This pre-licensing change of ownership (CHOW) inspection is for a Residential Facility for the Elderly being conducted for a one story, 6 bedroom, 2 bathroom home with a fire clearance approved for capacity of 6 non-ambulatory residents. Facility currently has 4 residents in care. There are currently 2 vacant rooms,1 shared room, 2 resident occupied rooms and one staff room. LPA and admin toured the indoor and outdoor portions of the facility. Facility was found to be clean and at a comfortable temperature. Outdoor patio furniture accessible for resident use. All resident bedrooms were found to be in clean and good repair. All had required chair, chest drawer and beds were made with appropriate linens. Restrooms had grab bars but lacked bath mats. LPA observed there to be emergency food and emergency water supply. However, emergency food was not sufficient to meet the 72 hour supply regulation for 4 residents. LPA advised admin to ensure emergency food supply is restocked. LPA observed there to be perishables to meet Title 22 Regulations. There were canned goods and non-perishable foods in pantry. Refrigerator and freezer were functioning and operational. LPA observed meats in freezer to not be labeled or have expiration dates. LPA had conversation with admin that all food in freezer must be labeled with expiration dated noted. LPA observed there to be plates and utensils including additional kitchenware. All cleaning products, sharp items, other toxins and chemicals are locked and inaccessible for residents. There are an ample amount of extra linens, towels, hygiene products and first aid kit. Facility has accessible and functioning phone for residents to communicate. Continued to 809C.... Continued from 809... LPA observed fire extinguisher charged and last inspected on 12/09/2024. Fire alarm and carbon monoxide alarms were tested and operational. Signal system on all doors leading out of facility were on, tested and found operational. Water was measured in faucets used by residents and was found to be within regulation between 105 & 120 degrees F. Medication is locked and inaccessible to residents. Refrigerated medication is centrally stored in lock box. LPA observed medication to be pre-poured for the following medication cycle. LPA spoke with admin that all medication must be kept in its original containers and cannot be pre-poured. Component III orientation read with administrator. Facility to provide pictures to CCL of the following items: - Emergency food supply for 72 hours - Expiration dates on all food items - Bath mats in both restrooms No Deficiencies given during visit. Pre-Licensing completed. Facility will be ready to be Licensed once CCL receive pictures of corrections mentioned. LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicants of Status. Copy of report discussed and provided to Applicants. Exit interview conducted.