Senior Care Records.

Facility Evaluation Report

Maple Tree Care Home, Santa Rosa11/21/2025Licence 496804267

Capacity6
Census4
Date signed11/21/2025 10:38:53 AM
Name of licensing program analystMarisol Cuadra
Name of licensing program managerBethany Moellers
The inspector’s account

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required Inspection and met with Jessica Mendoza, Licensee. Contact information reviewed. Required postings were observed. The facility has a hospice waiver for two residents and there is one resident receiving hospice services.

LPA/Licensee initiated a tour of the facility at 9:00 am and observed the following: Facility was a comfortable temperature and pathways were free from obstructions. All resident’s bedrooms have lighting & appropriate furnishings per regulation. Fire extinguishers were last inspected July 2025. Smoke detectors and the carbon monoxide detector were tested and operational during inspection. Auditory alarms installed at the doors that were tested and operational during the visit. Last Disaster drill was conducted on 8/10/25. Resident's bathrooms has required bath mat and grab bars. Water temperature in resident bathroom measured at 117.1 and 115.7 degrees F which is within the range allowed by regulation of 105 to 120 degrees F. Garage houses food pantry storage, laundry, incontinence care supplies, generator and emergency supply of water. Cleaning supplies are stored in a cabinet located in the garage and kitchen cabinet were inaccessible to residents in care. At least two days of perishable and seven days of non-perishable foods were available. Refrigerated food was found to be stored in a safe manner, some items were not labeled and dated per regulation, LPA had a conversation with the Licensee about the importance of labeling opened food with dates (technical advisory issued). Mediation and medication records were locked in the office by the hallway.

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