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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 405850222
Report Date: 01/09/2026
Date Signed: 01/09/2026 01:34:54 PM

Document Has Been Signed on 01/09/2026 01:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:LIFETOUCH THE ELEGANT LIVING RESIDENTIAL HOME CAREFACILITY NUMBER:
405850222
ADMINISTRATOR/
DIRECTOR:		AQUINO, AMELITA I.FACILITY TYPE:
740
ADDRESS:1934 TULIPWOOD DRIVETELEPHONE:
(805) 226-0994
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 6CENSUS: 2DATE:
01/09/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Lead Staff - Dennis PaguioTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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At 9:10am, on 1/9/2026, Licensing Program Analyst (LPA) Haner-Tomasko arrived at the facility unannounced to conduct the annual facility inspection. LPA met with Lead Staff Dennis Paguio and staff Mary Damasco, announced who he was and the reason for the visit.

Dennis, Mary, and LPA conducted a full tour of the facility. This facility is a single story residential home with four resident bedrooms (two are dual occupancy), three full bathrooms (two are en-suite to resident bedrooms and one is for shared use) and a staff bedroom is accessible from the backyard. There is a living room, dining space, and a kitchen. Access to the garage is through a locked door for resident safety. The laundry is behind accordion doors with locking cabinets for the chemicals. LPA noted that the backyard and the front yard both have seating and shade for residents and visitors. LPA noted fresh fruit in the kitchen for residents to enjoy freely. The facility has battery operated smoke detectors in each room that are all working, the carbon monoxide detector is near the front door and functioning normally. LPA observed a fire extinguisher near the kitchen that was tagged current and in the green compression range, serviced on 1/22/2025. At 9:29am LPA tested facility hot water at 130.1*(f) in the shared bathroom in the hallway, not within regulation temperatures 105*-120* (f). This facility has one hot water heater delivering water to all faucets. LPA observed at least 2-days of perishable and at least 7-days of nonperishable foods. During the tour the LPA noted the following items unattended and accessible to residents in care: at 9:27am LPA noted a can of Ajax and two aerosol cans of Febreze in the shared public bathroom in the hallway; at 9:42am lidocaine ointment, nail polish remover, ibuprofen, and Tylenol in the furniture next to the dining room table; at 9:45am ten bottles of over-the-counter medications in the furniture to the left of the garage door; at



(Continue LIC809-C)
NAME OF LICENSING PROGRAM MANAGER: Kelly Burley
NAME OF LICENSING PROGRAM ANALYST: Garrett Haner-Tomasko
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 11
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • 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.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 01/09/2026 01:34 PM - It Cannot Be Edited


Created By: Garrett Haner-Tomasko On 01/09/2026 at 12:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LIFETOUCH THE ELEGANT LIVING RESIDENTIAL HOME CARE
FACILITY NUMBER: 405850222

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87309(a)
Storage Space and Access
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when they left disinfectants, chemicals, and medications unattended and accessible to residents which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/10/2026
Plan of Correction
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Staff locked up items during LPA visit. Administrator stated over the phone they will conduct training with the staff on this regulation and email LPA training documents and signed staff roster on or before 1/16/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kelly Burley
NAME OF LICENSING PROGRAM MANAGER:
Garrett Haner-Tomasko
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/09/2026 01:34 PM - It Cannot Be Edited


Created By: Garrett Haner-Tomasko On 01/09/2026 at 12:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LIFETOUCH THE ELEGANT LIVING RESIDENTIAL HOME CARE
FACILITY NUMBER: 405850222

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87205(b)
Accountability of Licensee Governing Body
(b) If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above when the licensee/entity LIFETOUCH THE ELEGANT LIVING RESIDENTIAL HOME CARE (RCFE), INC was suspended per the California Secretary of State as of 5/1/2025 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/23/2026
Plan of Correction
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Administrator stated over the phone they will contact the accountant and/or Secretary of State on 1/12/2025 and let the LPA know via email or phone call why that is the case. Administrator will work to get the corporation in good standing on or before 1/23/2026.
Type B
Section Cited
CCR
87303(e)(2)
Maintenance and Operation
(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when LPA tested hot water at 130.1*F which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/10/2026
Plan of Correction
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Administrator stated they would contact a technician today and schedule a time for them to come lower the water temperature as soon as possible. Administrator will email LPA the date and time of the scheduled service. Administrator stated they would create a log to routinely check the water temperature.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kelly Burley
NAME OF LICENSING PROGRAM MANAGER:
Garrett Haner-Tomasko
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2026


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: LIFETOUCH THE ELEGANT LIVING RESIDENTIAL HOME CARE
FACILITY NUMBER: 405850222
VISIT DATE: 01/09/2026
NARRATIVE
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9:59am in the backyard a bottle of bleach and bottle of multi-purpose cleaner; at 10:00am an unlocked shed containing paint cans, a medication bubble pack and yard equipment; at 10:02am to the left of the shed a container with seven car cleaning chemicals. LPA noted that the facility is clean with no obstructions in hallways and doorways. Medications are locked in a cabinet in the kitchen area. LPA conducted a sample medication audit and reviewed the facilities Centrally Stored Medication Records. LPA conducted a staff and resident record review. LPA noted during facility file review the Licensee/Entity LIFETOUCH THE ELEGANT LIVING RESIDENTIAL HOME CARE (RCFE), INC is suspended per the California Secretary of State as of 5/1/2025.

LPA and Lead Staff conducted a review of the annual care tool modules. LPA spoke with Administrator Aimelita Aquino over the phone to review the visit together.

Exit interview conducted, deficiencies cited on LIC809-D pages, report signed, and report provided to the Lead Staff.

NAME OF LICENSING PROGRAM MANAGER: Kelly Burley
NAME OF LICENSING PROGRAM ANALYST: Garrett Haner-Tomasko
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC809 (FAS) - (06/04)
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