Facility Evaluation Report

On August 07, 2026, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Annual Inspection and met with the Administrator, Etta Simpson. 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 zero adult residents. For a 735 facility type. LPA Mixson toured the facility along with the Administrator, Etta Simpson, 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. Additionally, there were no bodies of water seen on the premises at the time of this visit. The facility is a two-story facility located at 26452 Avenida De LA paz. physical Plant: The facility phone number is (951) 498-1770, and it is operable. LPA Mixson observed the residents’ bedrooms, and each was furnished as per Regulations and Title 22. LPA Mixson inspected the 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 extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something,” the "Personal Rights." The cleaning supplies and sharp items were locked and inaccessible at the time of this visit. There were designated storage spaces for the residents’ and staff’s files, and it was locked. Medications : There was a location for the medication to be locked. Food Service& furniture: Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. The overall facility is clean; the furniture is in good condition and arranged in a manner which provides space. The facility cooling system and other appliances were operable at present. The Administrator informed LPA there were safety lights for night throughout the facility. Care & Supervision / Administration: The floor plans, telephone numbers and personal rights were found posted in the facility. The listed Administrator, Etta Simpson possess a current administrator’s certificate with an expiration date of 01/22/2028, and it is posted in the facility, near the front door. Records Reviewed and Resident/Staff Files: LPA Mixson reviewed staff files and the facility's staff schedule. The staff files reviewed comprise required documents, along with updated TB test. Disaster preparedness: LPA Mixson reviewed the facility's emergency and disaster plan as well as the disaster training binder. Infection Control: LPA Mixson observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to conduct regular cleaning of the facility. LPA reviewed the facility's infection control plan and found required infection control measures met the Department requirements. Gloves were observed in residents private bathrooms. An exit interview was conducted, where a copy of this report was reviewed and given to the Administrator, Etta Simpson.