Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Licensee Juanito Estamo, Continual Administrator's Certification for Maria Christine Estamo expires on 02/17/2026. There are currently 4 residents who reside at this home and there is 3 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. Bedrooms were 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 116 degrees. First Aid kit is on site and complete.

LPA observed the following deficiencies. Toxins and cleaning supplies accessible to residents in hallway bathroom. The facility has 3 residents currently under hospice care. Licensee did not notify Licensing of residents being admitted to hospice care. Resident 1 does not have annually updated Needs and Services plan. Facility does not have required disaster drills. Hospice binders do not have required staff training. Resident 2 is bedridden and this facility does not have fire clearance for bedridden residents. Resident 3 does not have a Needs and Services Plan, admission assessment, TB test or required consent forms. Staff 1 is not fingerprint cleared. Staff 2 does not have required TB test. Facility Emergency Disaster Plan does not have Fresno Regional Office contact information listed, and previous facility named is listed. Facility Emergency Disaster Plan was last reviewed/updated on 10/04/2021. Emergency Disaster Plan does not list Resident Assembly Points. Facility does not have current/updated resident roster. Resident 4 passed away on August 19,2025. The facility did not notify Licensing of resident passing. Resident 5's medication is not listed on Centrally Stored Medication record.

Citations will be issued during Informal Office Meeting at Fresno Regional Office.

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 Juanito Estamo, and copy of report left at facility.