Senior Care Records.

Facility Evaluation Report

Mendoza Care Home III, Vallejo10/15/2025Licence 486801219

Capacity6
Census5
Date signed10/15/2025 03:53:46 PM
Name of licensing program analystEthel Contreras
Name of licensing program managerKimberley Mota
The inspector’s account

At approximately 1:15, Licensing Program Analyst (LPA) Contreras arrived unannounced to complete required annual inspection and was greeted by Administrator (admin) Josephine Mendoza.

Fire extinguishers were observed to have been updated as of 9/24/2025

LPA reviewed 5 of 5 resident records. All required documentation was present. Physician reports were up to date.

LPA reviewed 4 staff records. All required documentation was present.

LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. No deficiencies. Centrally Stored Medication Log (CSML) up to date, one medication to be missing prescription number and one PRN not listed in CSML. LPA had conversation with admin to make sure CSML is carefully being inputted (Advisory given).

No Deficiencies cited during today's visit.

Exit interview conducted and report read with Administrator.

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