Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA was greeted and granted entry and explained the reason for the visit. Facility is licensed for four ambulatory and two non-ambulatory clients. Administrator Michael San Diego has an administrator certificate expiring on 10/05/2027.

LPA Lyman along with Administrator San Diego toured the facility at 8:08 AM. LPA toured the physical plant, checked food service, and reviewed facility documentation. The home consists of three client bedrooms, one common restroom, client restroom, one staff room, living room, dining room, and kitchen. LPA observed facility has constructed an office as well as a room in the garage. LPA reviewed floor plan and fire clearance and the two rooms are not approved by Fullerton Fire Department on the floor plan. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, and shower was free of mold/mildew. Water temperature measured between 104.0 and 104.7 degrees F in facility bathrooms. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including thermometer, tweezers and scissors as well as a first aid manual. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors and carbon monoxide detectors tested operational during today's visit. Fire extinguisher is fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for clients. LPA observed ample emergency food. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provided documentation of last fire drill conducted on 01/12/2026. CONTINUED ON LIC 809C DATED 03/30/2026