Facility Evaluation Report
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Licensee Lydia Magallanes Continual Administrator's Certification expired on 07/11/2025. Administrators Certification Bureau shows application for renewal Administrators certificate was submitted on 05/12/2025. There is currently 1 resident who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Residents bedroom is clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.
Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational Water temperature was tested at 120 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible.
LPA observed perishable food being kept at room temperature. LPA observed the facility refrigerator and cabinet area next to the facility refrigerator infested with ants. LPA observed squash and other prepared foods room temperature on counter tops. LPA observed the facility dining area is cluttered. Facility does not have Infection Control Plan available to review or Emergency Disaster Plan LIC610E. Facility does not have required proof of disaster drills. Licensee does not have staff records available to review. Licensee does not have complete Resident records available for review. Admission agreement does not have all required verbiage. Resident 1 does not have current Needs and Services Plan.
The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.
LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.
Exit interview conducted with Licensee, Lydia Magallanes, and copy of report left at facility
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction