Facility Evaluation Report
Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Volunteer Dave Cornejo. LPA met with Staff Arlyne Cornejo and the purpose of the inspection was discussed.
During the inspection, LPA and Staff Dennis Cornejo conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:
This is a one-story home with six resident bedrooms, one staff bedroom, three bathrooms, and attached two-car garage. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. The backyard has a shaded sitting area. LPA observed residents watching television in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew and faucets and toilets were operational. Water temperature tested between 112.2–114.0 degrees Fahrenheit. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with service tag dated November 6, 2025. Gas stove, microwave, laundry washer and dryer were observed to be operable. Medication cabinet was observed to be locked. LPA reviewed medication and medication administrator records for select residents and did not observe any discrepancies. LPA reviewed three resident files and two staff files. One of three resident files did not include results of an examination for Communicable tuberculosis; a Deficiency was cited on today’s date. LPA interviewed three residents and two staff.
Based on the observations made during today’s inspection, one deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction