Facility Evaluation Report
On this date January 30, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by facility staff after explaining the purpose for the visit. Licensee Carmen Rivas was present to assist with the inspection.LPA observed that Administrator Diane Antonini has a valid Administrator certificate which expires on May 29, 2026. LPA began a tour of the facility and observed the following.
The facility is a single-story home with five resident bedrooms, one staff room, two shared resident bathrooms, a living room, a dining room, a kitchen, and an unattached two car garage. LPA observed four residents in care, none of which are on hospice, and two caregivers present. LPA observed residents in the living room and their bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the entryway of the facility. LPA inspected the five resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, reading lamp, and enough storage space to store personal belongings. All resident beds had clean linens in good repair; meaning no strains or tears. LPA observed additional linens are stored in a hallway closet. LPA inspected the two shared resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars, slip resistant floor mats, and shower chairs. Faucets and toilets were operational. Hot water temperature measured between 115.8 and 117.4 degrees Fahrenheit.
LPA observed kitchen area to be clean, and free of any mildew and debris. LPA observed the facility to have a two-day perishable and seven-day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed cleaning supplies are stored in a locked kitchen cabinet under the sink. CONTINUED ON LIC809-C
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction