Facility Evaluation Report

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Jasmin Yatco.

Facility is licensed for 6 residents and has a current census of 6. There are 5 residents on hospice with current care plans on file. Water temperature was checked in the common bathroom which read at 119.1 degrees Fahrenheit. Fire Extinguisher was purchased January 4, 2026 and is within the safety regulation period. Smoke and carbon monoxide detectors were tested and in working order.

Jasmin Yatco Administrator's Certification expires May 23, 2026. Staff files were reviewed, are complete, and current. Resident files were reviewed, LPA observed routine visits not up to date for R1 and R2 to be missing a reappraisal. Facility provided a log for disaster drills that are conducted quarterly. First aid kit on site and complete. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications.

LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable.

Deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA is requesting the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Jasmin Yatco.