Facility Evaluation Report
On 7/7/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced annual required visit. LPA was met by the Caregiver, Celerina Matibag and explained the purpose of today’s visit. The facility has a census of 4. There are 3 permanent clients and 1 respite client.
The facility is a single-story structure located in a residential neighborhood. The facility consists of (4) client bedrooms, (2) client bathrooms, living room, kitchen, dining area, shaded patio, garage used for storage and laundry area. Facility maintains all required posting throughout the facility. LPA Shirley reviewed 3 staff records and all client files. LPA Shirley checked 1 clients medications.
LPA Shirley and Celerina walked through the kitchen and all appliances were in good working order. Knives were locked and stored under the sink in the kitchen, inaccessible to clients in care. The medications are locked and stored in a cabinet located in the dining room and inaccessible to residents. LPA observed a 3-day supply of perishable and a 7-day supply of nonperishable foods. The water temperature properly measured between 105-120 F.
Bedrooms 1-4 are occupied by residents and contain the mandated furniture. The (2) bathrooms are clean and operational. First aid kit is fully stocked with manual. There are no firearms in the facility. There are no bodies of water present. The facility is in good repair.
LPA Shirley and Celerina walked through all common areas. In the living room, kitchen, dining room there is ample seating and space for all residents. All rooms and walkways were clean, and clear of obstructions and hazards. All areas have ample lighting. All rooms, hallway, and living room have working smoke detectors. There is a charged fire extinguisher in the dining room, hallway and garage. The backyard is clean and clear of obstructions and hazards and there are no bodies of water present.
There were no deficiencies issued. An exit interview was conducted, and a copy of this report was provided to the Administrator, Jesus Chiong.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction