Facility Evaluation Report

On 01/15/2025, at 9:00 AM, Licensing Program Analysts (LPAs) P.Manalo and L. Fontanilla arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with a house guest who opened door, and explained the purpose of the visit. The Licensee, Yolanda, informed LPAs that the facility has guests staying. Care Staff, Josephine Abella , came shortly after. The licensee stated that there are no residents for over 3 years and that they want to change the facility license to RCFE. The facility’s fire clearance was approved for 3 non-ambulatory.

LPAs toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms and 3 bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPAs observed lighting in all rooms are adequate for the comfort and safety of potential residents. The hot water temperature was measured at 106 degrees Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition.

Smoke detectors were in operating condition during visit. Fire extinguisher was last serviced on 2/20/2024.

Carbon monoxide was observed not operational.

LPAs informed Licensee to notify CCLD if they start taking clients so that another inspection can be conducted.

There are no staff or client files for review.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.

Exit interview conducted with Administrator and/ or anyone who meet with. Appeal Rights and a copy of this report provided.