Facility Evaluation Report

Licensing Program Analyst (LPA) Vaid conducted an unannounced annual inspection visit. LPA was allowed entry by Caregiver- Silvia Valencia, caregiver- Brianna Mayorga. Jennifer Sandoval administrator was not available. LVN -Margaret Grancich and Kenny Yu-Licensee arrived shortly after and the purpose of the visit was explained. The facility had a capacity of six (6) with approved fire clearance of five (5) non-ambulatory, one (1) bedridden and six (6) hospice waivers. One (1) resident was bedridden. Three (3) residents on hospice. Five (5) non-ambulatory residents. Annual fees were current. Administrator certificate with the expiration date on 07/22/2025. Renewal was sent in late June 2025, pending.

This annual visit consisted of using CARE tools, physical plant, review of food supply/medications/ resident files/ staff files and residents/staff interviews. The facility is located in a residential area, a single-story home with six (6) client’s bedrooms, three (3) bathrooms, a living room, a kitchen, a dining room, an activity area, a laundry room and detached garage inaccessible to residents. Residents' bedrooms are in full compliance. Adequate linen and personal hygiene supply were observed. Kitchen was clean and maintained the required two (2) days perishable and seven (7) days non-perishable. Bathrooms inspected were clean, operable, with the required grab bars and non-skid materials in the shower. Hot water temperature was in a range of 105-120 degrees Fahrenheit which was within Title 22 Regulation guidelines. Facility maintains a comfortable temperature of 74 degrees Fahrenheit for residents. Dual combos device (smoke detector combined with carbon monoxide detector) were operable and hard-wired. Fire extinguishers were fully charged Auditory devices were operable. The last Fire/ Emergency Drill was conducted on August 2025. Outdoor activity area had a shaded patio with ample seating. Medication /resident files/staff files were centrally stored in a locked storage room and inaccessible to residents.

No deficiencies cited per California Code of Regulations, Title 22. An exit interview was conducted. This report was discussed and provided to LVN- Margaret Grancich.