Facility Evaluation Report

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Ronnie and Maybelline Ubungen, Administrators. LPA announced the purpose of the visit.

During visit, LPA toured the facility inside and out. LPA toured the garage area and observed food storage areas and locked cabinets for cleaning supplies. LPA observed the kitchen area and observed locked sharp objects, and cleaning supplies. LPA observed a locked closet in hallway for medication. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days.

LPA toured three resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. ADM tested the smoke detector in the hallway and found the smoke detector to function properly when tested. LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sinks measured with thermometer at 115.5 to 118.9 F.

LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 07/06/2026. LPA reviewed Fire and Earthquake log. The last disaster drill was conducted on 04/19/2026

LPA reviewed resident records including Centrally Stored Medication Record (CSMR) for 4 residents. LPA reviewed 3 staff records. 1 out of 4 resident was missing 1 medication on CSMR.

No deficiency were cited as per California Code of Regulations Title 22. Technical Violation issued see LIC9102. This report was reviewed with ADM and a copy of this report was provided.