Senior Care Records.

Facility Evaluation Report

Kun Bai Care #2 Home, Lake Elsinore06/25/2025Licence 331880822

Capacity6
Census2
Date signed06/25/2025 02:19:57 PM
Name of licensing program analystMary Rico
Name of licensing program managerEfren Malagon
The inspector’s account

Licensing Program Analyst (LP) Mary Rico conducted an unannounced case management visit pertaining to complaint control number 56-AS-20240624141719.LPA Rico met with staff Jair Melgarieio Martinez. The Licensee Sandy Zhao was contacted and informed of the visit. LPA Rico conducted staff interviews, resident interviews, facility tour and record review.

During facility tour, LPA Rico observed the facility did not have an Administrator present at the facility. Licensee Sandy Zhao stated that their Administrator and House Manager were off. A pervious licensing report was issued on 10/28/2024 giving notice on the same violation. Because you have been cited for repeating the same violation within 12months, the following civil penalty shall be assessed until the violation is correct.

In addition, LPA Rico reviewed resident records, LPA Rico observed R1(dementia) did not have their updated medical assessment. A pervious licensing report was issued on 10/28/2024 giving notice on the same violation. Because you have been cited for repeating the same violation within 12months, the following civil penalty shall be assessed until the violation is correct.

An exit interview was conducted where this report, LIC809, LIC809D, LIC421FC and Appeal Rights were discussed and provided to staff Jair Melgarierio Martinez

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