Pacific Coast at Maria Way

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced case management visit during a complaint visit. During the visit, LPA provided technical advise regarding hand-over-hand assistance. Hand-over-hand assistance is when the caregiver gently places their hand over the resident’s hand to guide the motion of eating without replacing the resident’s independence. LPA provided handouts with information on hand-over-hand technique. No violations were cited during the visit. An exit interview was conducted with Caregiver, Cindy Andrade whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Aug 5, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced case management visit. Upon arrival, LPA was greeted by staff member Claudia Lizardo, to whom LPA identified herself and explained the purpose of the visit. During the visit, House Manager Ray Cruz arrived at the facility. During the tour of the facility, LPA observed that construction was taking place in the garage area. Per House Manager Ray Cruz, the property owner is building an attached ADU. Ray stated that the garage is not part of the lease agreement for the home. However, a review of the facility sketch indicated that the garage is included as part of the licensed facility. LPA explained that the facility must submit an updated facility sketch and a Plan for Continuity of Operations while construction is taking place. The plan must include mitigating measures implemented to ensure the health and safety of residents residing at the facility are safeguarded during the construction process. Additionally, the plan should include notification to residents and their responsible parties/families regarding the construction and assurance that resident care and services will not be adversely affected. No immediate health or safety risks were observed during this visit, and no deficiencies were cited. An exit interview was conducted, and a copy of this report, along with Licensee Rights (LIC 9058, 03/22), was provided to House Manager Ray Cruz. His signature on this form confirms receipt of these documents.the state’s words, verbatim · CDSS document, May 20, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced case management visit. Upon arrival, LPA was greeted by staff member Claudia Lizardo, to whom she identified herself and explained the purpose of the visit. During the visit, LPA observed residents in care, completed a health and safety check, reviewed facility records, and conducted interviews with staff and residents. The purpose of today’s visit was to follow up on a self reported incident. On May 11, 2026, the Department received an incident report regarding an event that occurred on May 7, 2026, at 3:00 am Resident 1 (R1) approached Resident 2 (R2) in the living room. R2 had their pull up adult brief at their ankles. R2 stated that they requested for help to get their pull up brief on and R1 helped R2 and R2 claimed that R1 touched their private parts. R2 notified Staff 2 (S2) and Staff 3 (S3) at 6:00 pm on May 7, 2026, about the incident and Staff 2 reviewed video of the time of the incident. The video footage showed R1 assisting R2 and then their head moving close to R2's private area and R2 using their hand push R1 away. S2 reported the incident to the resident's responsible parties, their PACE care teams, filed a report with APS, filed a report with the local ombudsman, and notified Community Care Licensing. There was not a police report filed. No immediate health or safety risks were observed during this visit. Additional case management will be provided for this incident, including subsequent visits and staff interviews, as needed. An exit interview was conducted, and a copy of this report and Licensee Rights LIC 9058 (03/22) were left with the Director, whose signature on this form confirms receipt of these documents.the state’s words, verbatim · CDSS document, May 11, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an announced Pre-Licensing Inspection. The visit included a Component III orientation and a walkthrough of the facility's physical plant to evaluate compliance with Title 22, Division 6 of the California Code of Regulations and the California Health and Safety Code. Upon arrival, LPA was greeted at the front entrance by Administrator, Aleena Cruz and granted entry after properly identifying herself and stating the purpose of the visit. This facility applied to be licensed as a Residential Care Facility for the Elderly (RCFE). The fire clearance was approved on January 6, 2026, authorizing care for up to six (6) non-ambulatory adult residents. No bedridden residents are approved. As of today’s visit, no clients are in care. The submitted facility sketch matched the current physical layout. Facility Inspection LPA, accompanied by Administrator, Aleena Cruz, conducted an inspection of both the interior and exterior areas of the facility. The following observations were made: · The facility was clean, sanitary, and in good repair. · Required postings were displayed in visible locations. · There was sufficient space and equipment to support laundry, visitation, meetings, and resident activities. (continue at LIC809C) (continue from LIC809) Indoor and outdoor pathways were clear of obstructions and slip hazards. · Smoke and carbon monoxide detectors, emergency lighting, and a facility telephone were operational. · Fire extinguishers were purchased on December 16, 2025 and bore valid inspection tags. · All chemicals and toxic substances were stored in locked areas, inaccessible to residents. Bedrooms and Bathroom · Client bedrooms were equipped with the required furnishings, allowed for easy passage, and had windows with intact screens. · The facility had adequate linens and hygiene supplies available. · Both bathrooms were equipped with non-skid mats and grabbars · Toilet, sink, and two showers were fully functional. · The facility's ambient temperature was comfortable and compliant. · Hot water measured at 111°F, within the regulatory range. Kitchen and Storage · The kitchen contained appropriate cooking utensils and equipment. · Knives and other sharp objects were securely stored in a locked cabinet. · A 7-day supply of non-perishable and a 2-day supply of perishable food will be stocked upon resident admission. · Medications will be stored in a locked cabinet inside the facility. · A complete first aid kit and manual were available in the medicine cabinet. · Client and staff records will be stored in a locked cabinet. Additional Observations · Per Cruz, no firearms or ammunition are or will be stored on the premises. (Continue at LIC809C) (continue from LIC809C) Conclusion LPA reviewed and discussed ongoing operational requirements, recordkeeping, reporting obligations, and physical plant standards with the applicant. All items reviewed were in compliance with applicable regulations. The Pre-Licensing Inspection and Component III orientation were completed during today’s visit. The applicant was advised that the facility is ready for licensure, pending final review and approval by Licensing management. An exit interview was conducted with Cruz, during which a copy of this report and the Licensee Appeal Rights (LIC 9058, 03/22) were provided. The signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Mar 20, 2026

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Aleena Cruz, Administrator/Licensee and Ray Cruz, Licensee Interview Method: Virtual interview On 2/27/26, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 27, 2026