Facility Evaluation Report
Licensing Program Analyst (LPA) Rankin arrived at 1:08 pm and made an unannounced 1-year required annual visit to the facility above. LPA’s met with Licensee Amelita Antonio and Teresa Tolentino, administrator and explained the purpose of the visit.
A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit:
Physical Plant & Environment Safety: The facility has 5 bedrooms and 2 bathrooms currently occupying 6 residents. LPA was authorized to enter and inspect the facility. The facility has smoke and carbon monoxide detectors that were tested and were working at the time of visit. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secure grab bars are present. The showers have non-skid mats or non-skid flooring. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant and cleaning solutions are inaccessible to residents in care and are locked in a cupboard in the garage. The facility has sufficient space inside and outside for activities and visiting. The facility has a fenced backyard for client use with plenty of shade. The facility has a telephone and internet service for residents’ use. The fire extinguishers were last charged and inspected on 1/13/25.
Operational Requirements: The facility has a current plan of operation on file with the department. The facility has current liability insurance that expires on 1/30/26. The facility is operating in compliance with the granted fire clearance. The facility is approved for a capacity of 6, all 6 can be bedridden and a hospice waiver is approved for 2 residents.
Staffing Records & Training: The facility currently employs 3 full-time caregivers, 2 relief staff and 1 administrator. Staff records are kept confidential. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Continued 809-C
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction