Senior Care Records.

Facility Evaluation Report

Shasta Residential Care, Fountain Valley03/09/2026Licence 306006280

Capacity6
Census5
Date signed03/09/2026 04:54:41 PM
Name of licensing program analystEboni Bentley
Name of licensing program managerLourdes Montoya
The inspector’s account

On March 9, 2026, Licensing Program Analyst (LPA) Eboni Bentley conducted a case management deficiency visit after observing a deficiency while conducting complaint visit:22-AS-20260305084042.

Per record review, Staff #1 (S1) and Staff #2 are not associated to the facility. Per interview with Administrator Kevin Dinh stated, S1 began working at the facility on January 15, 2026 and S2 began working at the facility on October 20, 2025. Both S1 & S2 as full-time caregivers for 5 days per week. During today's visit, LPA observed S1 and S2 working at the facility and providing care to residents in care.

A deficiency was cited by Title 22 Division 6 Chapter 8. CIVIL PENALTIES ASSESSED.

An exit interview was conducted, and a copy of this report, LIC809-D, LIC811, LIC421BGand appeal rights were provided to Administrator Kevin Dinh.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction