Amalfi Living

Type of visit: Required - 1 Year

On 2/5/2026, Licensing Program Analysts (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Joanalyn Temporaza/House Manager. LPA explained the purpose of today’s visit. Facility is licensed for (6) ambulatory only residents ages 60 and above of which one (1) may be bedridden in room #4. Approved hospice waive for (6) residents. The home is a single-story home consisting of: (4) resident bedrooms, (2) full bathroom, a living room, kitchen with dining area, a garage (attached with a laundry area, an additional refrigerator and pantry items), a backyard with a shed, an outdoor shaded patio area and additional sitting area outside. LPA Iniguez toured the physical plant with an administrator. There were no bodies of water or obstructions on the premises. A total of (4) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected the carbon monoxide detectors combo were in operable condition. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene were observed. Sharps objects and cleaning agents were locked and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available at the property. All fire extinguishers were charged and were operable. A review of (3) resident records and (3) staff records were conducted. LPA Cross and Iniguez checked (3) Medication Administration Records (MAR) and no discrepancies were found. The first AID kit was checked. The last facility disaster drill was: 2/1/2026. LPA observed the facility's infection control practices. A copy of the liability insurance was given to LPA during this visit. Facility annual fees are current. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -House garage has been used as living quarters. Immediate civil penalty of $500.00 rendered. Type A citation. -Water temperature measured 132F. Type A citation. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. * An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Joanalyn Temporaza/House Manager.the state’s words, verbatim · CDSS document, Feb 5, 2026

Type of visit: Case Management - Incident

On 11/14/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Case Management – Incident visit to the facility listed above. LPA met with Licensee, Tina Cinco, and the purpose of today’s visit was explained. LPA was granted entry into the facility. On 11/09/2025, the Regional Office received an Unusual Incident/Injury Report (SIR) regarding an incident that occurred between Residents R1 and R2 on 11/09/2025. The report stated when Staff S2 entered the resident’s room, R1 was observed with blood on their face and pillow. Staff S2 immediately called 911 and paramedic arrived, treated R1 and suggested to call the police department. No incident was observed between Residents R1 and R2. R2's family decided to move them out of the facility. During today’s visit, LPA conducted a Health and Safety Check on all residents, interviewed Staff S1 and S2, interviewed Residents R1, R3-R6, and reviewed R2’s Physician’s Report and Appraisal/Needs and Service Plan. During interviews with Residents R1, R3-R6, were asked if they felt safe living in this facility, three (3) out of five (5) stated they feel safe living at the facility. Two (2) residents were unable to answer due to conditions. LPA was able to interview Resident R4’s responsible party (W1), who stated yes, they feel their family is safe living in the facility. During today’s visit, LPA did not observe or cite any deficiencies. LPA did not observe any immediate Health or Safety Concerns. An exit interview was conducted with Licensee, Tina Cinco, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 14, 2025

Type of visit: Required - 1 Year

On 03/10/2025 at 08:40 am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one year inspection. LPA met with Tina Cinco, Licensee and the purpose of the visit was discussed. Facility is licensed to age range 60 and over to serve six (6) non- ambulatory residents of which one (1) may be bedridden in Room 4 with a waiver/granted for hospice care for six(6) on 01.11.2024 by the department. Three (3) residents are diagnosed with dementia, two (2) residents are receiving home health, and two (2) hospice care services. The facility does not handle any of the residents’ money. The facility annual fees have been paid in full. The liability insurance is with James River Insurance (policy # 0091573-5) with each occurrence is $1,000,000 and general aggregate is $3,000,000 which is valid from 05/07/2024 - 05/07/2025. The home is a single story home consisting of: (4) resident bedrooms, (2) full bathroom, a living room, kitchen with dining area, a garage (attached with a laundry area, an additional refrigerator and pantry items), a backyard with a shed, an outdoor shaded patio area and additional sitting area outside. Between the hours of 9:28am - 9:45am, LPA toured the resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured at 120.4 (in bathroom #1), 118.0F (in bathroom #2) and 120.6 (in the kitchen). Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. LPA conducted a records review of (6) client records, (6) staff records, (6)Medication Administrator Records and reviewed the facility disaster plan. All client & Staff records were complete. The facility disaster plan was conducted on 02/01/2025 and in compliance with Title 22 at the time of visit. Report continues on LIC 809-C Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. Deficiencies cited under California Code of Regulations (Title 22, Division 6, Chapter 8); LPA observed the following deficiencies: On 03/10/2025, between the hours of 09:28 am - 09:45 am while LPA was conducting a tour of the physical plant, and observed Resident #3 located in Room #3. Upon, LPA reviewing the facility records (facility sketch, fire safety inspection request), between the hours of 10:10 am - 11:24am, LPA observe the facility license states bedridden resident must be located in Room #4. An exit interview was conducted Tina Cinco (Licensee), and a copy of Report and Appeal Rights provided.the state’s words, verbatim · CDSS document, Mar 10, 2025

Type of visit: Prelicensing

On 2/22/24 Licensing Program Analysts (LPA’s)Darneisha Cross and Alfonso Iniguez conducted a pre-licensing evaluation for an RCFE facility type. Today’s pre-licensing evaluation was conducted with authorized licensee: Tina Cinco. The licensee has applied for a license to serve (6) elderly residents ages 59 and older. The fire clearance is approved for (5) non-ambulatory and (1) bedridden. Bedroom #4 is approved for bedridden. A tour of the Kitchen, Dining Room, Living Room, (4) Bedrooms, (2) Bathrooms, Garage, Storage for all supplies, Back Yard with shade. The following was observed during this visit: MEDICATIONS There is a locked centralized storage area for Resident medications. PHYSICAL PLANT Facility is clean, sanitary, and in good repair. Protective devices are in place. Indoor and outdoor passageways, stairways, open porches, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair. Facility temperature is between 68°F. degrees and 73°F. degrees. Open porches, and areas of potential hazard are well-lit. Smoke alarms operate properly. Carbon monoxide detectors operate properly. Report continues LIC 809C. BEDROOMS There is a bed for each client with a mattress, mattress pad, bedsprings, and pillow(s) which are clean and in good repair. Mattresses and pillows are flame-retardant. There is dresser and closet space for each client that includes at least two (2) drawers or eight (8) cubic feet of dresser space per client. There is a chair and lamp for each client and at least one (1) nightstand per two (2) clients. BATHROOMS There is at least one (2) toilet and washbasin per six (6) clients, family, and personnel. There is at least one (2) shower or bathtub per ten (10) clients, family, and personnel. Hot water temperature is 113° Fahrenheit. Bathroom is located near client bedrooms. There are nightlights in the hallways outside non-private bathrooms. SUPPLIES There are client personal hygiene supplies to include soap, toothpaste, toilet paper, and comb. There is a sufficient supply of clean linens to permit weekly changing or more of client top sheets, bottom sheets, bedspreads, blankets, pillowcases, mattress covers, bath towels, hand towels, and washcloths. FOOD SERVICE Dining room is near kitchen. Refrigerator(s) and freezer(s) are clean and large enough for the storage of at least two (2) days of perishable foods. Freezer is 0° Fahrenheit. Refrigerator is a maximum of 45° Fahrenheit. A seven (7) day supply of non-perishable food is present. There are enough tableware, tables, dishes, and utensils. There is enough equipment for the storage, preparation, and service of food. All equipment, dishes, and utensils are clean and well maintained. All kitchen, food storage, and preparation areas are clean. Report continues LIC 809C. RECORDS There is confidential storage of personnel records at the facility. There is confidential storage of client records at the facility. ADMINISTRATION The emergency exiting plan and emergency phone numbers are posted. Client Personal Rights are posted. Posting both sides of the Personal Rights form LIC 613 meets this requirement. Facility Visiting Policy is posted. Licensing Complaint Poster is posted. There is space available for resident council meetings and resident council postings. ACTIVITIES There is an outdoor activity space with a shaded area and furnished for outdoor use. There is at least one common room available to clients for visitors. Report continues LIC 809C. MISCELLANEOUS There are first-aid supplies to include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual. There is space and equipment for laundry. There is a space for clean linen storage and a separate space for soiled linen. There is an operating telephone available to clients. Emergency lighting and supplies to include flashlights with batteries. A copy of the liability insurance was provided during this visit.Licensee will transfer land line from old facility once they moved here. During this pre-licensing inspection, LPA did not find corrections are needed. LPA conducted the Component III Orientation with the Licensee and copy of this report was provided. A copy of the facility evaluation report will be available to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with their assigned CAU Analyst. Exit interview conducted with Tina Cinco/Licensee.the state’s words, verbatim · CDSS document, Feb 22, 2024