Facility Evaluation Report
On 12/01/2025 at 11:20am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Romina Ocampo (Direct Care Staff) and Rommel Dungca (Licensee)and explained the purpose of today’s visit. The facility is licensed to serve (18) elderly adults ages 60 and above, of which (18) can be non-ambulatory. The facility has an approved hospice waiver for (4).
The facility has a current administrator certificate ( 7033913740 ) for Rommel Dungca valid 07/09/2025 - 07/08/2027. The facility fees balance is at $0. The liability insurance is current and is valid from 02/10/2025 - 02/10/2026 with James River Insurance Company (NAIC # 12203) - policy # #00140336-2.
The one-story residential home consists of ten (10) resident bedrooms, two (2) resident bathrooms, living room, dining room, family room, kitchen, office area, washer and dryer/ storage area, backyard with table and chairs.
Between the hours of 11:30am - 1:45pm, LPA conducted a records review of (7) client records, (5) staff records, (3) clients Personal & Incidental Records and reviewed the facility disaster plan. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (7) Client Medication Administration Records and did not observed any discrepancies at the time of visit.
Between the hours of 12:05pm - 12:30pm, LPA Brown and Rommel Dungca toured the inside and outside of the facility. All client rooms were checked. Mattresses and box springs were in good condition, adequate lighting was observed, plenty of dresser and closet space was observed. Walls and floors were clean and in good repair. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature properly measured between 105 -120F (115.7F in Bathroom 1).
The evaluation Report continues on the next page, LIC 809-C , providing further details of the inspection findings.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction