Facility Evaluation Report

On July 28, 2026, Licensing Program Analysts, (LPAs), Venus Mixson and arrived at the facility in order to conduct the Required Annual Inspection and met with the Administrator, Ogonna Onyemata. The facility file review was conducted in the Regional Office

and additional forms were reviewed and requested on site. The Facility is licensed for six(6) Adult Residents and is operating within its capacity. For a 735 facility type. LPAs toured the facility along with the Administrator and inspected the facility inside and outside. There were no observed clutter or debris to the indoor or outdoor passageways currently. The facility is a single story home located at 13675 Oliver Street Moreno Valley Ca. 92555. Physical Plant: The facility phone number is (951) 289-2731. LPAs observed the two resident bedrooms, and each was equipped with required furniture as per Title 22. LPA inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms had working appliances and were clean. The facility's smoke detectors, carbon monoxide alarms, and fire extinguishers were observed and operable. LPA Mixson observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings. The cleaning supplies and sharp items were locked and inaccessible to the residents in the kitchen closet. A designated storage space for the residents and staff files was observed, and it was locked and inaccessible to residents in care. The overall facility is clean,

The furniture is in good condition. The facility cooling system and other appliances were operable currently at the time of this visit. There were safety lights for night throughout the facility. Medications: The medications were locked and inaccessible to residents in care. There is a sufficient supply of medication for each resident currently, which is in bubble packs. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharps are locked. Care & Supervision: Facility has sufficient staff; two staff are on site at the time of this visit. Records Review: LPA Mixson reviewed resident files and staff files, conducted staff interviews, and reviewed previous Community Care Licensing forms. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was given to the Administrator, Onyemata Ogonna.