Camino Retirement Living

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Edward Kim made an announced visit to conduct the second pre-licensing inspection. LPA Kim was greeted and granted entry by Applicant Florela Gabriela Tatarici. LPA Kim explained the reason for the visit upon entry. The first pre-licensing inspection was made on March 16, 2026 and several corrections were needed. The applicant requested a capacity for 6 residents, of which are five (5) nonambulatory residents and one (1) bedridden resident. Applicant has requested a hospice waiver for two (2) residents. The facility is a one-story house in a residential neighborhood with an attached 2 car garage and 4 four car garage with seven (7) bedrooms, of which five (5) bedrooms are for residents, one bedroom (1) is for staff, and one bedroom for the operator, four bathrooms, family room, dining room, a kitchen, and living room with a screened fireplace. During a tour of the facility, LPA Kim observed the following items were corrected: 1) All Hospital beds were replaced with regular beds in bedroom #1, bedroom #3, bedroom #4, and bedroom #5. 2) Fire extinguisher receipt for the staff bedroom is attached with a purchase date of October 8,2025. 3) The four car garage door is locked and the applicant has a key to lock and unlock that door. 4) LPA observed and verified all smoke detectors and carbon monoxide detectors were in working order. The pre-licensing visit and Component III Orientation are now complete. This facility meets the requirements for licensure. LPA Kim will forward this report to the Centralized Applications Bureau for review. The license will be granted upon completion of a final review and approval from the Centralized Applications Bureau. An exit interview was conducted and a copy of this report was provided to applicant Florela Gabriela Tatarici.the state’s words, verbatim · CDSS document, Apr 1, 2026

Type of visit: Prelicensing

On March 16, 2026, at 8:00 AM, Licensing Program Analyst (LPA) Edward Kim conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA Kim met with Applicant Florela Gabriela Tatarici and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to CCL on February 23, 2025. The facility has a capacity of five (5) residents, of which five (5) can be nonambulatory and one (1) may be bedridden. Facility phone number (657-708-9261). LPA Kim observed the following. Structure: The facility is a one-story house with an attached two car garage and a four car garage with five (5) resident bedrooms, one (1) staff bedroom, family bedroom, four (4) bathrooms, dining area, family area, a kitchen, and a living area. The four car garage next to a storage area needs to be locked because there are power tools in it. Applicant stated they will add a lock to that door. There is a storage area next to the family ownership bedroom. There are six (6) exits: one exit door next to the living area, one in the main entrance, two exits in the family office area, one exit in the resident hallway, one exit in the family applicant bathroom, one in bedroom #1 which is the bedridden room, and one exit in bedroom #5. Resident Bedrooms: There are five (5) Resident Bedrooms: Bedroom #1, Bedroom #2, Bedroom #3, Bedroom #4, and Bedroom #5. The bedrooms are spacious and will easily accommodate the residents' belongings. All resident rooms had the furnishings. The following resident rooms have hospital beds. Bedroom #1 has one hospital bed, Bedroom #3 has one hospital bed, Bedroom#4 has one hospital bed, and Bedroom #5 has two hospital beds. Evaluation Report Continues on LIC 809-C. Staff Bedrooms: There is one (1) Staff Bedroom. There is a family applicant bedroom next to the family office area. Air/Heating: Central air/heating system installed with a central panel to control entire house located in living area. Bathrooms: All bathrooms have a working toilet, wash basin and shower. All bathrooms are clean. Shower mats were in all bathrooms. Hot water was measured in all bathrooms. Hot water measured between 113.5 degrees Fahrenheit to 114.0 degrees Fahrenheit. Linens & Hygiene Supplies: Adequate supply of linen stored in the facility. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed and posted in the resident hallway. Menus posted. Food Service: There are no residents living in the facility currently. There is a 2-day perishable food. There is 7-day non-perishable food supply on hand. The emergency food and emergency supplies are stored in the outdoor storage shed. Smoke Detectors/Carbon Monoxide Detectors: There are two (2) fire extinguishers. One is mounted on the wall in the kitchen and one mounted on the wall in the staff bedroom. The fire extinguisher in the kitchen is fully charged and was inspected on November 25, 2025. The applicant will send the receipt of the fire extinguisher mounted in the staff bedroom. Outdoor/Yard: There are two covered outdoor areas and it has enough furniture with a table and chairs in the backyard. There are two locked outdoor sheds in the backyard. One shed contains gardening supplies and feeding supplies for chickens. The other shed contains emergency supplies, emergency water, and Personal Protective Equipment (PPE). Evaluation Report Continues on LIC 809-C Toxins: All cleaning supplies and chemicals are kept in the garage, closet near the entrance, and locked underneath the kitchen sink. Medications, First-Aid Kit & Book: The first aid kit and all medications are stored and locked in a closet next to the entrance. Resident & Staff Files: The Resident and Staff Records will be kept locked in a closet near the entrance. Reading Material, Games, Equipment & Materials: Crossword puzzles, board games, and reading material are stored in a cabinet in the family area. There is a large screen TV in the living room and each resident room. There is a piano in the family area. Appliances: There is one five (5) gas burner stove which lights unassisted, oven, microwave oven, a refrigerator in the kitchen, dishwasher, washer, and dryer. All appliances are clean and operational. Fire clearance: Fire Clearance approved by Orange County Fire Authority on October 14, 2025. Component III: This will be conducted on the subsequent Pre- Licensing visit. During the pre-licensing inspection, LPA Kim observed the following items that must be corrected: 1) Hospital beds need to be replaced in bedroom #1, bedroom #3, bedroom #4, and bedroom #5. 2) Fire extinguisher receipt for the staff bedroom, or a new fire extinguisher with a receipt needs to be provided. 3) Need a lock on the four car garage door. The applicant plans on making the necessary corrections and contacting LPA Kim to schedule a follow-up pre-licensing inspection. Exit interview was conducted and a copy of this report was left with Applicant Florela Gabriela Tataricithe state’s words, verbatim · CDSS document, Mar 16, 2026

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Initial Capacity: 6 Census (if any clients in care): none COMP II Participants: Florela Tatarici, Applicant/Administrator Interview Method: Virtual interview (Microsoft Teams) On March 3, 2026, Applicant/Administrator participated in COMP II. Identification of the Applicant/Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant/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, Mar 3, 2026