Facility Evaluation Report

On August 05, 2026, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Annual Inspection and met with the Lead Staff, Villena Teodora. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. The facility is licensed for six adult residents and is currently operating within the scope of the license.

LPA Mixson toured the facility along with Villena Teodora, and made observations pertaining to the Required Annual visit. LPA inspected the facility inside and outside. There were no obstructions or debris to the indoor or outdoor passageways observed at the time of this visit. Additionally, there were no bodies of water seen on the premises. The facility is a single-story home located at 13852 Darwin Dr . Moreno Valley, CA. 92555.

Physical Plant: The facility phone number is (951)247-9792, and it is operable. LPA Mixson observed the four residents’ bedrooms, two are shared, and each was furnished as per Regulations and Title 22. LPA Mixson inspected the three facility bathrooms, and the hot water temperature tested within regulations, and was logged. The bathrooms were clean, and appliances were operating appropriately currently. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguisher. LPA Mixson observed required postings such as "If you See Something, Say Something,” and the "Personal Rights." 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.

Medications : Were locked in a industrial size medication cart in the kitchen area. It was inaccessible to residents in care. Additionally, there were a sufficient supply of medication for the residents. There were no documented errors observed on the centrally stored medication forms, and medications were stored in their original containers at the present. Currently at the facility are three caregivers for the six residents. LPA observed that there is one Fire extinguishers located in the kitchen next to the cabinets. It was serviced and in the green at the time of the visit. Last serviced on 04/06/2026, by the State Fire Marshall.