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Type of visit: Prelicensing

Licensing Program Analyst (LPA) Manuel Monter arrived announced to conduct a follow up visit from facility's pre-licensing visit on August 19, 2026. LPA met with Applicant (AP) Anabelen Vallarta. LPA explained the purpose of the visit. LPA toured the facility inside and out with AP. During today's visit, LPA Monter inspected the items which were unresolved during the pre-licensing visit on August 19, 2026. LPA observed the front gate of the facility has a clear surface, cleared of any protruding nails. LPA toured bathroom #2 and observed the shower curtain was installed. LPA toured bedroom 3's light room switch plate was replaced and new. LPA measured facility water temperature in bathroom #1, #2 and facility kitchen. Water temperature ranged from 114-116 degrees F. Pre-licensing deficiencies have been resolved. Pre-Licensing is now complete. LPA observed the facility is ready to be licensed. However, this report will be submitted to the Central Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. This report was reviewed with Applicant Anabelen Vallarta and a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 21, 2026

Type of visit: Prelicensing

On August 19, 2026, Licensing Program Analyst (LPA) Manuel Monter, conducted an announced pre-licensing inspection and met with Applicant Anabelen Vallarta. The facility is a Residential Care Facility for the Elderly (RCFE). The facility fire clearance is approved for 6 non ambulatory. At the time of inspection there are 0 clients observed. LPA and Applicant toured the facility inside and outside, which included the Living room, kitchen, dining room, 2 restrooms and 4 residents bedrooms. The front yard and backyard were inspected. There was no obstruction to block the walkways. LPA also toured the facility garage, which is being used as a storage space/laundry area/ car parking area. Applicant Anabelen Vallarta stated the RCFE does not have live in staff. During the visit LPA informed Applicant Anabelen Vallarta, that prior to construction or alterations, all facilities shall obtain a building permit. LPA advised Applicant Anabelen Vallarta if she decides to do any constructions or alterations to the facility, to notify CCL and ensure that any changes that are made have the necessary permits. The facility has 4 designated exit routes per LIC 610D (emergency and disaster plan), dated February 23, 2026. The exits are free from obstruction. The facility has carbon monoxide and smoke alarm detectors that are strategically placed throughout the building. The facility fire extinguishers are placed strategically in the kitchen/dinning area. The fire extinguishers were serviced on September 30, 2025. The laundry area is located in the garage. The laundry detergents, cleaning supplies and other toxic are locked and can only be accessed by staff. 4 Out of 4 resident bedrooms have adequate lighting, bed frames with mattress, linens, lamps, night stands, drawer dresser storage and closet space that is sufficient to store clients’ personal belongings. 2 Out of 2 bathrooms hot water temperature measured at 75 degrees Fahrenheit. Applicant stated they noted the issue with the water heater not heating the water this morning. Applicant stated they got in contact with the landlord to address this issue. Applicant stated they contacted a plumber to address this issue. Applicant stated they will contact LPA once it has been completed. Room temperature is at 70 degree F. The facility has a centralized air-conditioning system. Medication closet observed to be locked. First Aid kit was observed inside, which contained first aid supplies, with manual, tweezers and scissor. Facility kitchen equipment is functioning properly, LPA observed locked kitchen cabinet for sharps. LPA reviewed emergency disaster plan and confirmed its completeness. LPA observed cleaning products and chemicals locked an inaccessible to residents in care. Facility bulletin board contain all necessary documents. During todays visit, LPA noted that the facility has acquired a hospice for 4 residents. LPA noted to Applicant that the facility does not have any bedridden clearance. LPA advised Applicant that although a hospice resident might be able to reposition, there will come a time when they will not be able to and will be considered bedridden. LPA advised Applicant to request for bedridden clearance for her facility. During the visit, LPA noted the shower curtain in bathroom # 2 was missing. LPA noted the light switch cover in room 3 was broken. LPA noted the fence door has 3 screws that are jutting out of the fence door, revealing the tips of the screws. LPA advised applicant to address these issues as well. Pre-Licensing is incomplete with deficiencies to be resolved by August 20, 2026. A follow up Pre-licensure LIC809 will be generated upon resolution of deficiencies." Component III orientation was conducted with Applicant Anabelen Vallarta. This report was reviewed with Applicant Anabelen Vallarta and a copy of the report was provided. END OF REPORTthe state’s words, verbatim · CDSS document, Aug 19, 2026