The applicant is seeking licensure for a Residential Care Facility for the Elderly (RCFE) with a capacity to accept and retain up to five (5) non-ambulatory residents and one (1) ambulatory resident at any given time. The facility has an approved fire clearance for five (5) non-ambulatory residents and one (1) ambulatory resident. Bedroom #4 is approved for bedridden residents; bedrooms #1, # 2, #3, and #6 are approved for non-ambulatory residents; and bedroom #5 is approved for staff or ambulatory residents only. The facility has a dementia care plan on file and will provide care and supervision to residents 24 hours per day. At the time of the inspection, there were no residents in care. A brief interview was conducted with applicant Posadas. Mary Mata will serve as the Administrator of the facility. Administrator Mata holds Administrator Certificate #6070656740, which expires on 11/06/2026. The facility has completed an infection control plan and an emergency disaster plan, both of which were provided to Licensing for review and approval.

LPA toured the facility and reviewed the facility sketch. The physical plant was observed to be consistent with the approved fire clearance (STD 850). The facility was observed to be clean and in good repair. The kitchen area was inspected, including cabinets and drawers. Silverware, plates, and utensils were observed to be sufficient to meet the needs of residents. Knives were stored and inaccessible to residents. The facility refrigerator was observed to be functional and in good repair.

CONTINUED LIC 9099-C

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

The common and dining areas were furnished appropriately and provided sufficient seating to meet the needs of up to six residents. Smoke detectors and carbon monoxide detectors were observed to be in good working condition. A fire extinguisher was located in the kitchen and was last serviced on 11/19/2025.

Resident bedrooms were toured and found to be adequately furnished to meet resident needs. Hot water temperature measured 108.2 degrees Fahrenheit at the resident bathroom sink, which is within the required range of 105 to 120 degrees Fahrenheit. Resident bathrooms were observed to be equipped with non-slip mats; however, the main resident bathroom/shower did not have grab bars at the time of inspection. During the visit, the applicant’s maintenance staff went to Home Depot to purchase grab bars and installed two grab bars in the bathroom. The facility temperature was measured at 69 degrees Fahrenheit.

Medication storage areas were observed to be centrally located and locked in the staff room. The first aid kit was inspected and found to be complete. The facility maintains designated, locked storage areas for resident and staff records within the staff office. Required postings and documents were observed to be properly displayed. Activity supplies were observed to be available to residents in the dining area.

The courtyard was toured and observed to have sufficient furniture and shaded areas for resident use. The facility pool was observed to be surrounded by secure fencing.

The applicant has successfully passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing inspection has been completed and approved. Component III was reviewed with the applicant. An exit interview was conducted, and a copy of this report was provided to the applicant.