Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA met with designated Administrator (AD) Marciel Nepomuceno. An application to operate a Residential Care Facility for the elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by CCL on 4/24/2023.

At 11:50 a.m. LPA toured the facility and observed the following:

· The bed with pillows, linen, and blankets and staffs' personal belongings in the garage have been removed. Designated AD stated garage will solely be used for storage.

Component III : was conducted during this inspection, information provided about how to operate the facility within compliance and reporting requirements.

The facility is ready to be licensed. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau (CAB) in Sacramento. An exit interview was conducted, and a copy of this report was left at the facility.