Facility Evaluation Report

On 2/14/2026 at approximately 10:00 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by staff member (S3) and stated the reason for their visit. The Administrator, John Mallon arrived shortly after to assist with today’s visit.

Upon arrival, LPA observed two (2) staff members (S2-S3). assisting residents with their aspects of daily living. LPA observed S3 to be wearing Personal Protective Equipment (PPE) gloves while cleaning the facility. S3 stated their first day of employment was 2/14/2026 and they help lift and transfer residents. LPA’s record review of the California Department of Social Services Guardian Background Check revealed S3 to have background clearance as of 1/26/2025 but was not associated with this facility. Additional record review of the Licensing Information System (LIS) confirmed S3 was not associated with the facility. Further record review of the facility’s file revealed on 1/17/2024 they were cited for failure to associate/transfer another staff member. LPA informed the Administrator that all staff members must be fingerprint cleared and associated prior to employment.

LPA asked for the census, Staff/Resident Roster and Liability Insurance. LPA conducted a physical plant tour at approximately 2:00 PM and the following was noted:

The facility is a single-story building with five (5) bedrooms and three (3) bathrooms. The facility is currently occupying four (4) residents. There is a designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents. Hospice waiver approved for one (1).