Facility Evaluation Report

On June 6, 2025 at 8:30am, Licensing Program Analyst (LPA) Eboni Bentley conducted a case management annual continuation visit. Upon arrival at the facility, LPA Bentley was greeted and granted entry by the Caregiver (CG) Ramon Vera, and explained the reason for the visit. Administrator Zenaida Vera joined shortly after and was present throughout the visit. AD Zenaida Vera has an Administrator certificate that expires on November 13, 2025.

The facility is a single story building with an approved fire clearance of three non-ambulatory residents of which one may be bedridden and three approved for hospice. The facility currently has a census of one resident in care, of which one is on hospice. The one resident was present and eating breakfast.

During today’s visit, LPA requested records for facility liability insurance and AD Vera stated she did not currently have liability insurance for the facility as the previous policy had lapsed. AD Vera stated she reached out to her broker to request liability insurance on June 5, 2025 but could not provide documentation of current insurance policy at the time of the today's visit. LPA observed records of previous liability insurance policy provided by AD Vera, effective October 16, 2018 - October 16, 2019. No addition liability insurance documentation was provided.

Based on today’s observations, a deficiency is being cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations.

An exit interview was conducted with Administrator, Zenaida Vera and a copy of this report LIC809, LIC809-D, and appeal rights provided.