Facility Evaluation Report

On 05/19/25, Licensing Program Analyst (LPA) M. Yang arrived announced to conduct a follow-up of the Pre-licensing inspection from visit on 04/25/25. LPA introduced self, stated the purpose of the visit and met with Licensee Elsa Nguyen and Administrator Maria Ceballos.

1. Facility has fire clearance for 44 non ambulatory, 15 maybe bedridden with total capacity of 44. Fire clearance granted for non ambulatory/ bedridden for delay egress.

2. Facility was toured with Licensee. Bathrooms hot water temperature tested at 105.9 in bathroom 1, 106.5 in bathroom 2, 108.3 in bathroom 3, 106.3 in bathroom 4, and 106.1 bathroom. 5.

3. First Aid kit was observed with all required items.

Component III was conducted during today's pre-licensing visit.

I have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB

in Sacramento for final review prior to license being issued. A copy of this report was provided to