Senior Care Records.

Facility Evaluation Report

Good Samaritan Care Home, Fairfield06/06/2025Licence 486802010

Capacity6
Census4
Date signed06/06/2025 03:17:04 PM
Name of licensing program analystAli Deniz
Name of licensing program managerVictoria Bertozzi
The inspector’s account

On 06/06/2025 at approximately 12:45PM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by Staff, Delilah Ardiente. Licensee, Brenda Garcia arrived during visit at approximately at 12:55PM.

Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. The facility currently approved for capacity of 6 residents. Facility has an approved hospice waiver for 1 individual. Upon arrival, LPA was informed that there were 4 residents in care and 2 staff members on-site. Facility is a 1 story building with 4 Resident bedrooms, 2 bathrooms, and common spaces.

At approximately 1:30 PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 1:45PM, LPA and Licensee toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Staff were in the process of cleaning up kitchen at the time of this inspection. Toxins are stored in a locked housekeeping closet in laundry room and in the kitchen cabinet under the sink. Water temperature measured 110.6 degrees F and 113.4 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents.

Fire extinguishers bought new on 11/26/2024. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a room in next to the dining room.

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