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Facility Evaluation Report

Kathleen Care Home, Diamond Bar09/04/2025Licence 197606887

Capacity6
Census5
Date signed09/04/2025 02:00:21 PM
Name of licensing program analystBennette Pena
Name of licensing program managerDavid Sicairos
The inspector’s account

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA was met by Victoria Valera and Edmar Limoico, Care Staff and explained the purpose of the visit. Shortly after, Administrator Orlando Valera arrived and assisted LPA with the inspection. The facility is approved to serve elderly clients. Fire cleared for (6) non ambulatory clients. Hospice waiver approved for (2) clients. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Bathroom has hygiene items such as paper towel, hand soap and toilet paper.

Operational Requirements: A fire clearance is in place. Fire Drill is conducted monthly and the last drill was conducted on 08/05/2025. Facility has working signal systems in exit points.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood which consists of (4) resident bedrooms, (1) staff bedroom, (1) office/bedroom, (2) bathrooms, living room with covered fireplace, kitchen, dining area, laundry area in the attached garage and backyard with shaded patio area. There are currently (5) residents, 60 years and older residing in the facility, no one is under hospice care. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. LPA observed cameras in the common areas with no audio. Backyard was inspected and has a shaded area and sitting area. There are (2) fire extinguishers in the facility which was purchased on 12/30/2024. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature reading measured within the required 105 - 120 degrees Fahrenheit. 10:50am, readings were 114.4 deg. F in bathroom #1 and 113.9 deg F in bathroom #2. *****REPORT CONTINUED ON LIC809-C*****

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