Pre-licensing visit·May 28, 2026

At approximately 9:40 AM, Licensing Program Analyst (LPA) Magdaleno arrived announced to conduct a Pre-Licensing Inspection and met with Applicant Harley Leyto. Facility received an approved fire clearance dated 11/05/2025 that allows for a total capacity of six (6) residents, where six (6) can be non-ambulatory and one (1) can be bedridden. Facility has a hospice waiver for two (2). Facility plans to be a Residential Care Facility for the Elderly (RCFE) At approxi mately 9:50 AM LPA conducted a walk-through of facility with Applicant and observed the following: Per facility sketch, facility is a one story residence with four (4) residents bedrooms, two (2) bathrooms, one (1) half bathroom, a living room, a dining room, a laundry room, and a garage. Facility was found to be clean and at a comfortable temperature with all exits free from obstructions. Facility has an Infection Control plan on file. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply . Facility has sufficient items for cooking and serving. Water temperature measured between 106.5 degrees F and 119.8 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. There was a sufficient supply of cleaning products, linens, hygiene products, and paper products available for resid ents. Toxins will be locked in laundry room and inaccessible to residents. Bathrooms were equipped with necessary grab bars, and non-slip floors mats were present. All resident rooms were furnished with a bed, lamp, dresser, and chair with shared rooms containing two (2) of each. Medication cabinet was observed locked. Facility has indoor/outdoor areas for visiting and activities. Facility's fire extinguisher was observed to be charged and last inspected 11/25. Facility's smoke and carbon monoxide detectors were tested and operational. LPA confirmed that contents of the facility's First Aid Kit was sufficient. Facility has internet accessible devices and internet available for residents in care. LPA and Applicant discussed many topics including reporting requirements, documentation requirements, grievance procedures, staffing, disaster drills, and yearly training requirements. No Deficiencies or Advisories given during visit. Pre-Licensing completed and Component III presentation conducted with Applicant. Facility is ready to be Licensed as a Residential Care Facility for the Elderly (RCFE). LPA will submit Pre-Licensing Application Report to the Application Unit Analyst. Application Unit Analyst will notify Applicant of Status. Exit interview conducted with Applicant, whose signature on form confirms receipt.