Alaya I

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection visit. LPA was greeted by staff Lianne Valery Barbasa. Facility administrator unable to attend. Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for six residents. There are currently 4 residents in care. LPA toured the building and grounds which was found to be clean. All required postings were in a highly visible area. Strong odorous smell throughout facility and resident rooms (Deficiency Cited, See 809-D). Facility was at comfortable temperature. LPA observed all walkway in room down the hall to be obstructed with a metal curtain pole(Technical Violation given). Fire extinguishers were charged and last inspection. Fire alarms and carbon monoxide detector were tested and operational. Outdoor emergency exit clear from obstruction. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable foods. Food was stored properly with expiration dates noted. Toxins are stored in a locked cabinet and inaccessible to residents. Sharps and knives were locked in kitchen drawer. Facility had an ample supply of linens, towels and extra hygiene products for residents. Resident bathroom had required bath mat and grab bar. Water temperature measured at 105 degrees F at faucets accessible to residents which is within the allowable range of 105 to 120 degrees F. Resident bathroom door needs to be repaired. Bathroom door is a folding door that cannot close all the way. LPA observed door to be cracked throughout the folds and not in good repair. (Deficiency Cited, see 809-D). Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. LPA will arrive at another day to complete inspection. Copy of report given and read with staff.the state’s words, verbatim · CDSS document, Sep 30, 2026

Type of visit: Post Licensing

At approximately 10:20, Licensing Program Analyst (LPA) Contreras arrived unannounced to conducted a post-licensing visit. LPA was greeted by staff Bryan Gonzalez and Giselle Marin. Administrator(admin) Miguel Santos arrived shortly after. Facility is an Adult Residential Facility for the Elderly that has an approved fire clearance for capacity of 6 ambulatory and non-ambulatory residents. There are currently 5 residents at facility. LPA and admin toured all buildings and grounds and were found to be clear from obstruction. Facility was found to be clean and at a comfortable temperature. All emergency outdoors exit that could pose an obstruction were clear. All required postings were visible. There was a sufficient supply of nonperishable foods as required by Title 22 Regulations. LPA did not observe enough perishable food for 5 residents. Staff stated groceries are bought every Wednesday of the week. LPA had conversation with admin that a 2-day supply of perishables need to be in the refrigerator at all times (Technical Violation given). LPA observed expiration dates noted on all food items. Emergency food and water observed. All resident rooms were observed to be clean and have the proper linens. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Hot water temperature for sinks found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility's fire extinguisher was observed to be charged and last inspected on 12/04/25. Smoke and carbon monoxide detectors were tested and operational. Disaster drills are being conducted since licensed with last drill done on 1/12/2026. Continued to 809C.... continued from 809.... LPA conducted a file review check for 4 residents. All documentation found to be in file. One Admission Agreement(AD) still awaiting signature from POA for new facility name. All other AD have been updated since change of ownership. LPA conducted staff file review for 2 staff. All documentation and training up to date. LPA conducted medication spot check and found Centrally Stored Medication log up to date and medication locked and secure. No deficiencies cited during todays visit. Exit interview conducted. Copy of report discussed and provided to Licenseethe state’s words, verbatim · CDSS document, Feb 11, 2026

Type of visit: Prelicensing

At 10:00am Licensing Program Analyst (LPA) Contreras arrived for a scheduled pre-licensing visit and was greeted by administrator (admin) Juan Miguel Luis Santos. This pre-licensing change of ownership (CHOW) inspection is for a Residential Facility for the Elderly being conducted for a one story, 6 bedroom, 2 bathroom home with a fire clearance approved for capacity of 6 non-ambulatory residents. Facility currently has 4 residents in care. There are currently 2 vacant rooms,1 shared room, 2 resident occupied rooms and one staff room. LPA and admin toured the indoor and outdoor portions of the facility. Facility was found to be clean and at a comfortable temperature. Outdoor patio furniture accessible for resident use. All resident bedrooms were found to be in clean and good repair. All had required chair, chest drawer and beds were made with appropriate linens. Restrooms had grab bars but lacked bath mats. LPA observed there to be emergency food and emergency water supply. However, emergency food was not sufficient to meet the 72 hour supply regulation for 4 residents. LPA advised admin to ensure emergency food supply is restocked. LPA observed there to be perishables to meet Title 22 Regulations. There were canned goods and non-perishable foods in pantry. Refrigerator and freezer were functioning and operational. LPA observed meats in freezer to not be labeled or have expiration dates. LPA had conversation with admin that all food in freezer must be labeled with expiration dated noted. LPA observed there to be plates and utensils including additional kitchenware. All cleaning products, sharp items, other toxins and chemicals are locked and inaccessible for residents. There are an ample amount of extra linens, towels, hygiene products and first aid kit. Facility has accessible and functioning phone for residents to communicate. Continued to 809C.... Continued from 809... LPA observed fire extinguisher charged and last inspected on 12/09/2024. Fire alarm and carbon monoxide alarms were tested and operational. Signal system on all doors leading out of facility were on, tested and found operational. Water was measured in faucets used by residents and was found to be within regulation between 105 & 120 degrees F. Medication is locked and inaccessible to residents. Refrigerated medication is centrally stored in lock box. LPA observed medication to be pre-poured for the following medication cycle. LPA spoke with admin that all medication must be kept in its original containers and cannot be pre-poured. Component III orientation read with administrator. Facility to provide pictures to CCL of the following items: - Emergency food supply for 72 hours - Expiration dates on all food items - Bath mats in both restrooms No Deficiencies given during visit. Pre-Licensing completed. Facility will be ready to be Licensed once CCL receive pictures of corrections mentioned. LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicants of Status. Copy of report discussed and provided to Applicants. Exit interview conducted.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 06 Census : 04 Method: Telephone call with CAB COMP II Participants: SANTOS, JUAN MIGUEL Administrator/Licensee participated in COMP II via telephone call with CAB analyst. Identification of the Administrator/Licensee was verified by confirming driver’s license number. During COMP II, Administrator/Licensee confirmed the understanding of Title 22. Component II was successfully completed. Administrator/Licensee was advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Administrator/Licensee'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, Oct 6, 2025