Annika's Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual inspection using the Compliance and Regulatory Enforcement (CARE) Tool. Upon arrival, LPA was greeted by Facility Administrator Teresita Maralit, and the purpose of the visit was explained. The facility's fire clearance is approved to serve six (6) non-ambulatory residents, ages 60 and older, of which one (1) resident may be bedridden in Bedroom #3. The facility also has an approved hospice waiver for six (6) residents. At the time of the inspection, there were no residents residing at the facility and no staff providing care or supervision. The Administrator was present during the inspection and assisted LPA with the annual inspection. Facility Tour & Observations: Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present. Physical Plant Here is a revised version with the grammar corrected and the observations stated more clearly for the annual report: Physical Plant and Environmental Safety: The facility is located in a residential neighborhood and is a single-story home consisting of five (5) resident bedrooms, one (1) caregiver corridor, three (3) bathrooms, one (1) of which is a private resident bathroom, a living room, family room/sunroom, kitchen/dining area, attached garage w/washer and dryer, front yard, and backyard. All resident bedrooms observed contained the required furnishings, including beds, mattresses, linens, dressers, chairs, and adequate lighting. LPA observed designated areas for the storage of sharps, cleaning supplies, and other potentially hazardous items under lock and inaccessible to residents. Due to the facility currently being unoccupied, LPA observed that the facility was in need of general cleaning. Dust and residue were observed throughout various areas of the home, including the resident bedrooms, bathrooms, and common areas. The Administrator was informed of the observed conditions and the need to ensure the facility is thoroughly cleaned and maintained prior to residents returning to the facility. (continued on 809C) The bathrooms were observed to be in need of cleaning. Bathrooms were equipped with required safety features, including grab bars near the showers and toilets and non-skid mats. The hot water temperature was measured and observed to be outside the required regulatory range of 105°F to 120°F. Extra linens and towels were available and stored in the hallway. Smoke and carbon monoxide detectors were tested and found to be operational. Fire extinguishers were observed and available at the facility. LPA observed a swimming pool on the premises. The pool was surrounded by a gated enclosure. The front and backyard areas contained shaded outdoor seating for resident use. All passageways and exits were observed to be clear and unobstructed. Food Service: The refrigerator and freezer were observed to be operational and maintained at appropriate temperatures. No food was stocked or stored at the facility, as there are currently no residents residing at the facility and no staff providing services. Health-Related Services and Resident Records: There were no resident records or medications available for review, as there are currently no residents residing at the facility. Disaster Preparedness: The LIC 610D Emergency Disaster Plan was available for review. Emergency supplies, including water, food, flashlights, batteries, and first-aid supplies, were observed and available at the facility. Personnel Records and Training: There were no staff records available for review, as there are currently no staff working at the facility. Administrator Teresita Maralit's Administrator Certification was reviewed and found to be current and valid. An exit interview was conducted with Teresita Maralit, Administrator . During the inspection, deficiencies were observed and cited on the attached LIC 809D/809C in accordance with Title 22, Division 6 regulations. A copy of this report, LIC 809D/809C, and appeal rights will be provided.the state’s words, verbatim · CDSS document, Aug 25, 2026

Type of visit: Prelicensing

The narrative section of the state’s online copy of this report is blank.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an announced subsequent Pre-Licensing inspection visit. LPA met with applicant Teresita Mararlit and explained the purpose of the visit. On 08/15/2025 LPA Gonzalez conducted the initial Pre-Licensing inspection visit which consisted of a physical walk through of the house’s interior and exterior, inspections of resident bedrooms, bathrooms and common living areas. The purpose of today’s subsequent visit is to conduct a tour to address corrections required to meet Title 22 regulations. LPA observed the following corrections: · All three (3) resident bathrooms water temperature measured within department regulations of 105-120 degrees F, measured at 109.7, 105 and 106. · All trash bins observed to have lids · Sides of the home cleared of debris · Home is free of pests and bugs. LPA observed contract for regular pest control services to be provided monthly by Terminix Door chimes observed on doors leading outside, were tested and operable. continued on LIC 809C continued from LIC809 LPA tested pool gate and observed gate opens away from pool and self-latches. LPA observed the surrounding area did not have any objects that can be used to climb over the fence. • PIN 24-03-ASC, Subject: Safety Requirements for Facilities with Pools and Other Bodies of Water • LIC 311F, Records to be Maintained at the Facility- Residential Care Facility for the Elderly Facility made all corrections and is now ready for license. A copy of this report was provided to applicant. LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, Licensee has been instructed to communicate with the CAB Analyst who assigned his application.the state’s words, verbatim · CDSS document, Sep 2, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an announced Pre-Licensing Inspection visit and met with Applicant Teresita Maralit. The facility has an approved fire clearance to be licensed to serve a capacity of six (6); five (5) non-ambulatory, one (1) bedridden residents ages 60 and over. LPA and Applicant toured the physical plant interior and exterior. The Pre-Licensing Inspection CARE Tool was used. The following was observed/inspected: The facility is a single-story home located in a residential area of Glendora consisting of: kitchen, dining area, living room, staff room, five (5) resident bedrooms, three (3) bathrooms, front yard, backyard with a pool and an attached garage. The kitchen contained locked cabinets for securing centrally stored medication and facility/resident files. First aid kit and current manual were observed stored in the kitchen. The refrigerator was clean and stocked with adequate food supply of 2-day perishables, and 7-day non-perishables in the pantry. Sharps were observed secured and inaccessible. Cleaning supplies observed secured under the kitchen sink. LPA observed bugs under the kitchen sink. Applicant indicated they would get Terminix out to treat the facility. LPA requested proof, in the form of receipts, of the pest control service once completed. continued on LIC 809C page 2 Dining area is located in the kitchen. Living room has a fireplace with a covered screen. Staff room is accessible through the living room. Hallway linen closet contained surplus clean linens. Residents bedroom were observed to have the required furniture and sufficient lighting and storage. Resident beds were observed to have clean linens. LPA observed windowsills to be dirty with dead bugs. Applicant stated they would have it cleaned. Water temperature was checked in three (3) bathrooms and measured below 105 degrees F. Applicant stated they would address the low water temperature by end of day. LPA requested proof, in the form of a video of thermometer showing running water measuring with the range of 105-120 degree F, submitted once corrected. Walkways on both sides of the exterior of the home contained debris. Applicant stated the debris would be cleared by end of day. LPA requested proof, in the form of photos, to be sent once debris has been cleared. LPA observed the backyard to have a covered seating area and a pool which was made inaccessible through fencing. Carbon and smoke combination detectors were observed throughout the facility, were tested and are operable. The facility has two (2) fire extinguishers, and both are observed to be charged. Comp III was not conducted due to Applicant being a licensee and having other facilities. Facility did not meet the physical plant/inspection requirements as required per California Code of Regulations Title 22. continued on LIC 809C page 3 The following Corrections need to be made prior to clearing the facility for License: · All faucets must have cold and hot water within department regulations of 105-120 degrees F · All trash bins must have lids · Sides of the home needs to be cleared of debris · Home shall be free of pests, bugs Exit interview conducted and a copy of this report was provided to Applicant. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.the state’s words, verbatim · CDSS document, Aug 15, 2025