Tranquility at Tiger RCFE

Type of visit: Prelicensing

At approximately 11:00 a.m. on 07/07/26, Licensing Program Analyst (LPA) Nicholas Reed conducted an announced prelicensing inspection. LPA met with the administrator and disclosed the reason for the visit. LPA and the administrator reviewed Component III at 11:15 a.m. Today's prelicensing inspection is an initial application with no residents in care. The facility is a single story building with six (06) bedrooms, three (03) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (06) nonambulatory residents. Bedroom #4 is designated a staff room. The facility plans to serve residents with dementia. Approved hospice waivers for six (06). The front entrance was unlocked. Both front and back yards were maintained. At the front door, LPA observed postings for the facility sketch, administrator certificate, emergency disaster plan, personal rights, theft and loss policy, rights of resident councils, confidential complaint contacts, and ombudsman contacts. A screening station contained a visitor log, resident log, sanitizer, and digital thermomter. Walls, floors, windows, screens, and blinds were clean and in good repair. At 12:00 p.m. LPA measured the room temperature to be 76 degrees Fahrenheit. The living rooms contained a television, reading materials, board games, and furniture in good repair. A fireplace was appropriately covered. At approximately 12:15 p.m. LPA observed two (02) fully charged fire extinguishers in the kitchen and in the hallway. They were inspected on 07/06/26 and had tags attached. LPA observed an adequate supply of perishable and non-perishable foods in the refrigerator, freezer, and pantry. Appliances were clean and in good condition. The stove hood was clean. A weekly menu was posted on the refrigerator. A medication lock box was observed in the refrigerator. Sharps were locked below the counter top. Cleaning solutions were locked below the sink. Medications, confidential files, and a fully-stocked first aid kit were locked above the counter tops. Hallways contained night lights and closets. Two (02) closets contained hygiene supplies, incontinence supplies, and adequate amounts of fresh linens. The laundry room was locked and contained an operable washing machine and dryer as well as hygiene and cleaning supplies. The facility has six (06) bedrooms. The staff bedroom was free of hazards. All bedrooms contained a lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition. One (01) bedroom is shared and has a private bathroom. The facility has three (03) bathrooms. All bathrooms contained paper towels, liquid soap, trash cans with tight fitting lids, grab bars near the toilet and shower, and a non-skid mat in the shower. At approximately 12:40 p.m. LPA measured the water temperature to be 105.8 degrees Fahrenheit. At 1:00 p.m., smoke and carbon monoxide detectors were tested and operational. Adequate space and shaded seating were observed in the back yard. Exit paths were free of debris and tripping hazards. The rear exit gate was unlocked from the inside. The garage was locked and contained extra supplies, tools, and paint. Three (03) out of three (03) auditory alarms were tested and functioning. Pre-Licensing is complete and this facility has no deficiencies. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 7, 2026

Type of visit: Office

Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): COMP II Participants: NICOLE DE LAS ALAS/APPLICANT AND RAQUEL D'AMBROSIO/ADMINISTRTOR Interview Method: Telephone interview On 6/9/26, 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 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, Jun 9, 2026