Evercare Manor

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Jessica Cho arrived announced for the purpose of conducting a Pre-Licensing visit using the Care Inspection Tool. LPA conducted the visit with Applicant Priscilla Celis and Administrator Liza Rebecca. An initial application to operate a Residential Care Facility for the Elderly (RCFE), age range 60 and over, for (6) non-ambulatory, of which (1) may be bedridden was received by the Department on March 23, 2026. All bedrooms are approved for non-ambulatory or bedridden, where only (1) bedridden resident can be served at one time with a waiver granted for care for (6). LPA toured the interior and exterior portion of the facility and observed the following accompanied by the Applicant Priscilla Celis and Administrator Liza Rebecca. Structure: The facility is a single story property in a residential neighborhood. The facility is comprised of four (4) private resident bedrooms, (1) shared resident bedroom, (1) shared staff bedroom, and (2) full resident bathrooms. There is a living room, formal dining area, office, kitchen, laundry room, an attached two car garage, and a backyard. The backyard has one exit gate on one side of the property. There is a shaded seating area. LPA did not observe any obstacles or hazards in the backyard. Signal System: The facility utilizes a signal system where staff is alerted from a central location located in the kitchen area via the call buttons. Bedrooms: The resident bedrooms had all required components, are spacious, and easily accommodates the residents’ furnishings. Bathrooms: Bathrooms were clean and operational. Grab bars were secure and slip resistant mats were in place. Linens and Hygiene Supplies: Clean linens and hygiene supplies were observed to be fully stocked. Appliances: Stove burners, microwaves, washer, and dryer were inspected, new, and operating. Resident and Staff Files: Resident and staff records will be maintained on site in the kitchen. Reading Material, Games, Equipment, & Materials: The facility maintains activities and games in the formal dining room. Emergency Phone Numbers/Exit Plan: Posted in the medication cabinet and available for review upon request Postings: The See Something, Say Something (PUB475) and the Ombudsman Posters were posted in the entry area of the facility. Also posted were the Rights of the Resident Councils, Resident's Rights, Theft & Loss Policy, Activity Schedule, and Food Menu. The Admission Agreement is in the medication cabinet and will be available for review upon request. Food Service and Menu: Facility exceeded the seven day non-perishable and two day perishable food supply. The sample menu was available. The emergency food/water supply was also available. Smoke and Carbon Monoxide Detectors: The dual functioning smoke/carbon monoxide detectors, (2) carbon monoxide alert systems, and auditory devices were tested and found to be operational. Fire Extinguisher: One fire extinguisher was mounted, fully charged, and purchased on March 28, 2026. . Fire Clearance: Approved on April 15, 2026 for (5) non-ambulatory residents and (1) bedridden resident. Toxins and Sharps: Cleaning supplies, toxins, and sharps were secured and inaccessible. Water Temperature: The water temperature in the resident bathrooms measured at 116.6 in the primary and 117.8 degrees Fahrenheit in the second bathroom. Medications, First Aid Kit & Manual: The First Aid Kit was checked and found to be in order including the First Aid Manual. Component III: Component III is waived due to the applicant currently operating a licensed facility and having completed the training previously. The Pre-Licensing is now complete, and the facility is ready for licensure. The license will be granted upon completion of a final review and approval from the Licensing Program Manager and the Central Applications Bureau. An exit interview was conducted with Applicant/Administrator Priscilla Celis and Administrator Liza Rebecca, and a copy of this report was provided at the end of the visit.the state’s words, verbatim · CDSS document, Jun 5, 2026

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: PRISCILLA CELIS Interview Method: Telephone interview On May 26, 2026, 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 the understanding of the California Code Title 22 Regulations. 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. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 26, 2026