Facility Evaluation Report
On 10/27/2025 at 12:45pm, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one year inspection. LPA met with Jose Umana , Administrator and the purpose of the visit was discussed. The facility is licensed to serve 6 non- ambulatory of which 1 may be bedridden (bedroom #5 approved for bedridden) and approved for two (2) hospice waivers. The facility has four (4) of the residents are diagnosed with dementia, one (1) hospice, zero (0) home health resident and zero (0) bedridden resident. The facility does not handle any of the residents’ money.
The facility has a current administrator Jose Umana has a certificate 7001004740 (valid 07/06/2025 - 07/05/2027). The last fire drill was conducted on 09/10/2025 The facility has liability insurance with James River Insurance Company (NAIC#12203) with an effective date as of 08/01/2025 - 08/01/2026 with each occurrence at $1,000,000 and general aggregate at $3,000,000 (Policy #001200934).
The home is a single story home consisting of: (6) resident bedrooms, (4) full bathrooms, living room, kitchen with dining area, laundry room (located in the hallway) and an outdoor shaded patio area.
Between the hours of 1:22pm - 3:00pm LPA reviewed (6) resident records, (6) staff records (1) Hospice Care Plan and and (6) Client Medication Administration Records. The last disaster drill was conducted on 09/10/2025.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction