Senior Care Records.

Facility Evaluation Report

TLC Adult Home, Pine Grove03/27/2025Licence 037003702

Capacity3
Census1
Date signed03/27/2025 04:29:07 PM
Name of licensing program analystArvin Villanueva
Name of licensing program managerStephen Richardson
The inspector’s account

On 3/27/2025 Licensing Program Analyst (LPA) Arvin Villanueva arrived unannounced to conduct an annual inspection. LPA met with Administrator Carolyn Meeks, and stated the purpose of the visit. During this visit, there were 1 resident in care with 1 staff on duty.

LPA and Administrator toured the facility to ensure compliance with Title 22 regulations. LPA observed that there is still a For Sale sign at the entrance of the facility. Per administrator, she is still in the process of selling the property and still waiting for a buyer.

LPA observed the resident bedroom. The bedroom were observed to have necessary furniture and furnishings. The bathrooms were observed to be clean and free from debris.

The hot water was measured at 110 degree F during this visit. Room temperature was observed at 75 degrees F.

The facility is equipped with an emergency supply of food and water, a supply of perishable foods for seven days, and a supply of non-perishable food for a minimum of two days. The facility is equipped with an all house generator and solar power should the power go out.

Fire extinguishers were observed to be in working condition and were last serviced on 6/3/2024. Smoke detector and carbon monoxide detector were observed.

Medications, sharps, and cleaning supplies were observed to be locked away and inaccessible to residents in care.

LPA reviewed client file and staff file. Facility conducts monthly fire drills.

LPA obtained copy of the following documents: LIC 500 Personnel Summary and Surety Bond.

An exit interview was held with Administrator Carolyn, and a copy of the report was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction