Senior Care Records.

Facility Evaluation Report

Benicia Angel's Home 1, INC., Benicia08/28/2025Licence 486801831

Capacity6
Census3
Date signed08/28/2025 01:07:24 PM
Name of licensing program analystAnthony Loera
Name of licensing program managerKimberley Mota
The inspector’s account

08/28/2025, Licensing Program Analyst (LPA) Loera arrived unannounced to continue an Annual Required inspection that was initiated on 08/05/2025, and was greeted by caregiver. During arrival, LPA observed residents to be interacting in activities. Administrator, Evelyn Bayon arrived shortly after.

LPA conducted review of three resident records. All records had the required documentation. LPA conducted review of three staff records and training. Upon a review of staff records, LPA found all staff to have required initial training as well as current 1st Aid & CPR certification on file.

LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record.

Facilities last fire/emergency drill was conducted on 05/03/2025.

No deficiencies cited during today's inspection. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 09/28/2025:

LIC9020- Register of Facility Clients/Residents

Exit interview conducted with Administrator and a copy of this report was provided.

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