Facility Evaluation Report

On January 23, 2026, Licensing Program Analysts (LPAs), Venus Mixson and Ivashia Wright arrived at the facility unannounced to conduct the Annual Inspection and met with the Administrator, Laquita Carraway. 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 three adult resident. For a facility type of (735).

The LPAs toured the facility along with the Administrator Laquita Carraway, and made observations pertaining to the annual visit. The LPAs 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 tie of this visit. The facility is a single-story home located at 1294 Periwinkle Place San Jacinto, CA. 92582.

Physical Plant: The facility phone number is (714) 833-0484, and it is operable. The LPAs 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. The LPAs 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.

Medications : Were locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident. There were no documented errors observed on the centrally stored medication forms, and medications were stored in their original containers at the present. The facility has three caregivers present.