Mariposa.Sc740.LLC

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Marcella Tarin conducted an announced pre-licensing inspection to follow up on corrections to be resolved by 4/24/2026. LPA met with Applicant Carlos Castro. LPA stated the purpose of the visit. The facility does not have any residents. During today's visit, LPA measured the water temperature in 10 residents bathrooms, with a range from 108.6 F to 114.2 F. LPA observed lights fixtures in Bedrooms 9 and 10 to be functioning properly when tested by the Applicant. LPA observed the following posters in the facility hallways Licensing Complaint Poster, emergency telephone numbers, personal rights, resident council rights and facility sketch. LPA observed the facility's 2 exterior perimeter gates to no longer be locked with a keypad. LPA observed the gates to be latched, and functioned properly when tested by the Applicant. Pre-Licensing corrections have been resolved. Pre-Licensing is now complete. Component III orientation was completed with Applicant. No issues noted during this pre-licensing inspection. LPA observed the facility is ready to be licensed. However, this report will be submitted to the Centralized 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 Carlos Castro and a copy of the report was provided.the state’s words, verbatim · CDSS document, Apr 28, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Marcella Tarin conducted an announced pre-licensing inspection. LPA met with Applicant Carlos Castro. LPA stated the purpose of the visit. During visit, LPA toured the inside and outside of the facility to include the kitchen, dining, living room, 10 residents rooms, back and front of the facility. The facility has cameras located in the facility common areas and exterior of the facility. No bodies of water were observed. Facility temperature maintained at 69 F. LPA observed the facility to be clean, safe, sanitary and in good repair. Based on the facility fire clearance, the facility is approved for a capacity of 14, with 13 NON-AMBULATORY of which 1 may be BEDRIDDEN. Bedridden or non-ambulatory residents can occupy the following rooms: 1, 4, 6, 7, 8, 9, 10. All exit and passage ways were free and clear of obstruction. LPA observed a nonperishable food supply of 7 days and a perishable food supply of 2 days. LPA observed sharp supplies in a locked box in the kitchen. Fire extinguisher was inspected on 8/4/2025. The facility fire protection system was inspected on 11/26/2025 by a third party agency and passed inspection. The fire protection system functioned properly when tested by the Applicant. LPA observed medications would locked in a hallway closet inaccessible to residents in care. LPA toured 10 Resident bedrooms. LPA observed Bedroom 1 to have personal belongings. Applicant stated he was currently residing in the room. Bedrooms 1, 4, 6, 7, 8, 9 and 10 have an exit doorway leading out to the exterior of the facility. LPA observed in Bedrooms 9 and 10, the light flickered when turned on. Page 1 of 3 Applicant stated he would replace the light fixtures to ensure they are working properly and not flicker. The facility does not have any staff bedrooms. LPA toured resident bathrooms and observed the bathrooms to have functioning lights, covered trash bins, and hand soap. LPA measured water temperature in 10 resident bathrooms with a range from 73.4 F to 109 F (1 bathroom water temperature reached 109 F briefly-Bathroom #2). LPA advised Applicant to have the facility water heaters inspected due to the water temperature not within range from 105 F to 120 F (87303 Maintenance and Operation). Applicant stated understanding and would have the water heaters inspected. LPA observed the facility's laundry room with a washer, dryer. The laundry room is locked and inaccessible to residents in care. The laundry room is located across from Bedrooms 5 and 6. LPA also observed toxins secured in locked cabinets in the laundry room. LPA did not observe the following posters to include the Licensing Complaint Poster, emergency telephone numbers, personal rights, resident council rights and facility sketch. LPA advised Applicant to ensure the above mentioned posters were posted in the facility as noted in HSC.1569.33(h)(2), HSC1569.267, and HSC1569.157. Licensee stated understanding. LPA observed monitoring devices are in place at the facility front and back door, which play an auditory sound when a facility door is opened, which can be heard throughout the facility. Applicant stated he would be installing additional alarms on all facility doors that play an auditory sound when opened. LPA observed the facility to have 2 locked (keypad) exterior perimeter gates. LPA advised Applicant that the 2 locked exterior perimeter gates were a safety concern, and the keypads needed to be removed. Licensee stated understanding, and stated he would remove the keypads and ensure the perimeter gates were not locked. LPA advised Applicant perimeter fences with locked gates shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents. Applicant stated understanding. LPA observed dark spots on the ceiling in the facility kitchen pantry. Applicant stated he would have the area cleaned. Page 2 of 3 LPA observed 2 sheds on the side of the facility. The sheds were locked and inaccessible to residents in care. Applicant unlocked sheds and LPA observed gardening supplies in the sheds. LPA also observed wooden pallets, granite tiles, gardening supplies and buckets in the facility backyard. Applicant stated these items were going to be removed, placed in the sheds or thrown away. Applicant states he will be using his personal vehicle to transport residents, until additional vehicles are purchased. Pre-Licensing is incomplete with corrections to be resolved by 4/24/2026. A follow up Pre-licensure LIC809 will be generated upon resolution of corrections. Areas of corrections were discussed during today's visit with the applicant, which included the facility physical plant. No deficiencies were cited per California Code of Regulations, Title 22. An exit interview was conducted with Applicant Carlos Castro and a copy of this report was provided. Page 3 of 3 END OF REPORTthe state’s words, verbatim · CDSS document, Apr 9, 2026

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 14 Interview Method: Telephone interview On 3/18/2026, 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 18, 2026