Senior Care Records.

Facility Evaluation Report

A Home 4 Wayne, INC. 2, San Jacinto12/19/2025Licence 331881036

Capacity4
Census2
Date signed12/19/2025 10:17:52 AM
Name of licensing program analystVenus Mixson
Name of licensing program managerJazmond D Harris
The inspector’s account

On December 19, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to the facility to conduct a Health and Safety, case management visit, and met with the Assistant Administrator, Patrick Watson. The LPA made introductions and stated the purpose of the visit.

The Regional Office (RO), received the Fire Safety Inspection Request on 12/16/2025, indicating that the facility Fire clearance was granted. By the Riverside County Fire Department.

The Administrator informed the LPA that currently two residents reside at this facility, with a capacity of four. There were two staff on duty during the time of the visit. During today’s visit, the LPA toured the facility along with the Assistant Administrator and made observations pertaining to the facilities request to include non-ambulatory residents along with the ambulatory residents.

LPA observed the facility utilities to be operating without issues; the medications were locked and inaccessible to the residents in care. The food supply met the regulation requirements. The staff and resident files were found to have the required items per regulations. The facility is two stories, with seven bedrooms and three bathrooms. The residents will utilize four bedrooms and two bathrooms.

The bedrooms were furnished with required items as per regulations at the time of this visit. The facility has adequate linens, towels and a sufficient amount of hygiene products for the residents in care currently. The water temperature was tested and logged, along with fire drills. The smoke and carbon monoxide alarms were observed and are operable. Fire extinguishers are present in the facility and fully charged, and in the green.

The hallways were equipped with night lights. The kitchen was observed to have dishes, silverware, pots, and pans. The knives/sharp items are inaccessible to the residents in care. The staff and resident files, along with the medication were found to have no observable issues at the present time. There is no immediate concern for residents in care.

No deficiencies were observed or cited and per California Health & Safety Code and Code of Regulations, Title 22, Division 6.

An exit interview was conducted, and a copy of this report was explained and provided to the Assistant Administrator, Mr. Watson.

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