Facility Evaluation Report

On November 12, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Annual Inspection and met with the House Manger, Mary Smith. LPA introduced herself and stated the purpose of the visit. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. The facility is licensed for four adult residents and is currently operating at the capacity of four adult resident. Facility type (735).

LPA Mixson toured the facility along with the House Manager, Mary Smith, and made observations pertaining to the annual visit. LPA inspected the facility inside and outside. There were no obstructions or debris to the indoor or outdoor passageways observed currently. Additionally, there were no bodies of water seen on the premises currently. The facility is a single-story home located at 31922 Bay Laurel Street Menifee, CA. 92584.

Physical Plant: The facility phone number is (951) 430-1429, and it is operable. LPA Mixson observed the residents’ bedrooms, and each were furnished as per Regulations and Title 22. LPA Mixson inspected the facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something,” the "Personal Rights," and the LTCO poster. The cleaning supplies and sharp items were locked and inaccessible to the residents in care presently. There were designated storage spaces for the residents’ and staff’s files, and it was locked and inaccessible to residents in care at present.