Av RCFE, Oldfield

Type of visit: Required - 1 Year

On 03/17/2026 Licensing Program Analyst (LPA) Lorena Casillas conducted an announced annual visit to this facility. LPA arrived at 9:30 am, however, there was no one at the facility. LPA called and spoke to Administrator Fernando DeGuzman who stated that they were on their way to the facility. Administrator arrived shortly after. LPA spoke to Administrator and explained the reason for the visit. Entrance interview conducted. Infection Control and Emergency Preparedness Plan: LPA reviewed facility Infection Control Plan and Emergency Preparedness Plan to make sure protocols are being reviewed and/or updated. Plans were discussed and updated. At 11:30 am LPA began the facility tour with the Administrator and the following was observed. The facility has no residents currently living in the home therefore the tool kit was not used during this visit. The facility has a fire clearance for five (5) non-ambulatory residents and one (1) bedridden resident. The facility has six (6) approved hospice waivers. Common Areas: LPA observed the living room to be neat and clean along with the dining room. The facility maintains a comfortable temperature at 71°F. The smoke detectors and carbon monoxide detectors were tested and observed to be operational. Bedrooms: There are three (3) bedrooms for resident use, which contain beds, a mattress on each bed, linens, nightstand, lamp, chair, chest of drawers, and a closet. All window screens were in good repair. Continued on LIC809-C Kitchen: The facility has a seven-day supply of non-perishable foods and will have a two-day supply of perishable foods when residents are acquired. There are two (2) fire extinguishers, one is located in the kitchen and the other in a hallway, both were full and last purchased on 02/20/26. Appliances in the kitchen appeared to be functional. The medication will be locked in a medication cabinet which is stored on the kitchen counter. The knives are located in a locked kitchen drawer. The kitchen appeared to be clean and clear of clutter and free of pests. Bathrooms: There are two (2) bathrooms that are equipped with hand soap, paper towels, grab bars, slip resistant mats and trash cans with lids. The water temperature was tested at 12:00 pm and was within regulation at 112°F. Laundry/Garage: The washer and dryer were in the garage and appeared to be in good repair. There is a hallway closet that was locked and contained cleaning solutions. A hallway cabinet contained linens and personal hygiene items. LPA observed additional stored items in the garage. Surrounding Grounds: The backyard contained comfortable seating. The side gate leading from the backyard to the front yard was not locked. Passageways were clear of obstructions. LPA observed door alarms throughout the facility, and they were observed to be functional. Resident & Staff files: No current residents or staff, files were not reviewed. Resident & Staff interviews: No interviews conducted as there are no residents or staff. Administrative: All fees are current. No citations issued. Exit interview conducted. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 17, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Lorena Casillas met with the Licensee/Administrator Fernando De Guzman for an unannounced Case Management visit for this facility. On 01/23/2026 LPA Casillas received an email from Licensee/Administrator stating that they would like to surrender their license and close the facility. LPA arrived at 09:40 am, Licensee informed LPA that they do not have any residents as they were not able to secure any since opening. The Licensee is no longer interested in keeping the facility open and wishes to cease operation due to focusing on family. Licensee states that they have plans to lease the home. A tour of the physical plant was conducted with Licensee. The facility has three (3) bedrooms and two (2) bathrooms. Facility is currently not occupied by residents. Facility has been absent from residents since first being licensed. LPA confirmed that there are no residents in the facility. During visit Licensee had questions regarding a change of ownership (CHOW) as a potential option in leu of relinquishing their license at this time. LPA was able to answer Licensee's questions and Licensee decided to keep facility open until the potential CHOW is further discussed. Licensee mentioned that there is a potential entity that would be interested in a CHOW, they just need to meet and finalize their decision. At this time Licensee has decided that they would like to keep their license and will keep LPA informed on what the next steps will be. Exit interview conducted. A copy of this report provided to Licensee.the state’s words, verbatim · CDSS document, Feb 11, 2026

Type of visit: Required - 1 Year

On 01/15/2025, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced annual visit to this facility and met with the Administrator Fernando De Guzman. The facility has a fire clearance for five (5) non-ambulatory residents and one (1) bedridden resident. LPA arrived at 9:30 am, there was no one at the facility. LPA called and spoke to Administrator who stated that they were on their way to the facility. Administrator arrived shortly after. LPA spoke to Administrator and explained the reason for the visit. Entrance interview conducted. While LPA was waiting for Administrator LPA noticed a smell of natural gas. Upon entry to the home LPA noticed that there was a strong smell of natural gas. LPA and Administrator exited the building and emergency services were called. Southern California Gas company and the Fire Department arrived shortly after, found there to be a leak in a valve on the boiler located in the garage. This will be immediately repaired. Once the home was cleared LPA and Administrator resumed the annual visit. At 11:30 am LPA began the facility tour with the Administrator, the following was observed. The facility has no residents currently residing therefore the tool kit was not used during this visit. Common area: The living room contained comfortable seating. The family room contained comfortable seating and games. The room temperature was at a comfortable 68°F. Smoke detectors and carbon monoxide detector were tested at 12:00 pm and were observed to be operational. The dining area was neat and clean with sufficient seating to accommodate all residents. Continued on LIC809-C Kitchen: The facility has a seven-day supply of non-perishable food and will have a two-day supply of perishable foods when residents are acquired. There are two (2) fire extinguishers, one is located in the kitchen and the other in a hallway, both were full. Appliances in the kitchen appeared to be functional. The medication will be locked in a medication cabinet which is stored on the kitchen counter. The knives are located in a locked kitchen drawer. The kitchen appeared to be clean of clutter and free of pests. Bedrooms: There are three (3) bedrooms for resident use, which contained beds, a mattress on each bed, linens, night stand, lamp, a chair, chest of drawers, and a closet. All window screens were in good repair. Bathrooms: There are two (2) bathrooms which contained hand soap, paper towels, grab bars, slip resistant mats and a trash can with a lid. The water temperature was tested at 12:10 pm and was within regulation between 105°F and 120°F. Laundry/Garage: The washer and dryer were in the garage and appeared to be functional and in good repair. There is a hallway closet that was locked and contained cleaning solutions. A hallway cabinet contained linens and personal hygiene items. LPA observed additional stored items in the garage. Surrounding grounds: The backyard contained comfortable seating. The side gate leading from the backyard to the front yard was not locked. Passageways were clear of obstructions. LPA observed egress delayed alarms throughout the facility, and they were observed to be functional. Resident and staff files: No current residents or staff, files were not reviewed. Medication: There are no medications as there are no residents. Resident and Staff interviews: No interviews conducted as there are no residents or staff. Administrative: All fees are current. No citations issued. Exit interview conducted. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Jan 15, 2025

Type of visit: Prelicensing

On 01/04/2024, Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced pre-licensing visit to this facility and met with the Administrator and the business partner. This is a new application and a fire clearance dated 10/24/2023 was received for five (5) non-ambulatory residents and one (1) bedridden resident. The facility phone number is 661-418-0425.. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. Component III was conducted with the applicant from 9:15 am until 10:20 am. Today’s site visit consisted of LPA touring the physical plant inside and outside from 10:35 am until 11:10 am. LPA Spaeth observed the following: Common Areas – The living room contained comfortable seating. The dining room table and chairs are located in the kitchen. The family room contained comfortable seating and games. Kitchen - The facility contained a seven-day supply of non-perishable food and a two-day supply of perishable foods. A fire extinguisher is located in the kitchen. Appliances in the kitchen appeared to be functional. The knives and medications were locked in a medication cabinet which is stored on the kitchen counter. The pantry contained emergency food and water. Backyard - The backyard contained comfortable seating. The side gate leading from the backyard to the front yard was not locked. Continued - 809C Bedrooms - There are three (3) bedrooms which contained beds, a mattress on each bed, linens, night stand, lamp, a chair, chest of drawers, and a closet. Bathrooms- There are two bathrooms which contained hand soap, paper towels, grab bars, slip resistant mats and a trash can. The water temperature was recorded at 11:11 am and was 110. degrees F. Hallway - The hallway closet was locked and contained cleaning solutions. A hallway cabinet contained linens and personal hygiene items. Garage- LPA observed the garage was locked and contained the washer and dryer. The smoke/carbon monoxide detectors were tested at 11:30 am and were operable. The facility was clean and appears to be in good repair. LPA observed the egress delayed alarm was functional. This report will be forwarded to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. Exit interview was conducted with Licensee. A copy of this report was signed and delivered.the state’s words, verbatim · CDSS document, Jan 3, 2024

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: Name - Fernando de Guzman CEO/Administrator Interview Method: Telephone interview On November 6, 2023, 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 the 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, Nov 6, 2023