Facility Evaluation Report
On 11/06/2025 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a required 1 year annual inspection. LPA met with Administrator Adi Lina Tuiloma and explained the purpose of the visit.
LPA and Administrator conducted a tour of the interior and exterior of facility. Areas toured include but not limited to two (2) shared bedrooms and two (2) private bedrooms, three (3) bathrooms, staff room, kitchen, common areas. LPA observed required furniture, and lighting throughout the residents' bedrooms and facility. In areas toured no immediate health and safety concerns. LPA observed food supplies of non-perishables for a minimum of seven (7) days and perishable foods for a minimum of two (2) days. Toxins, cleaning supplies and knives are locked and inaccessible to residents in care. Fire extinguisher was last inspected on 10/16/2025. LPA observed required Licensing posters posted throughout the facility.
LPA reviewed five (5) resident files. Resident files contain signed admission agreements, physician's reports, appraisals, identification sheets, releases, and resident's rights. LPA reviewed three(3) staff files. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current training completed. LPA conducted a medication review of five (5) residents medications.
No deficiencies are being cited as a result of todays inspection.
Exit interview conducted and copy of the report and LIC809G was left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction