Facility Evaluation Report

On 05/05/2025, Licensing Program Analysts (LPAs) Triel Lindstrom and Arielle Pascua arrived at the facility to conduct an unannounced annual inspection. LPAs Lindstrom and Pascua identified themselves, explained the purpose of the visit, and asked to meet with the Designated Facility Administrator (DFA). DFA Voica Matis arrived at the facility and a brief interview followed. DFA Matis accompanied LPAs Lindstrom and Pascua on the tour of the facility.

This facility is a single-story residential home licensed to serve five non-ambulatory residents and one bedridden resident. It has a hospice waiver for two residents. Its fire clearance was issued by Modesto Fire Department on 09/28/23. The current census is five, including one resident on hospice. There were three staff on duty at the time this inspection, Arnel Arban,Ulna Tarrazona, and Rainilda Clavano.

The annual inspection began with a records review. LPA Lindstrom requested all staff files. The review revealed that there are current records for health screening, required training, and first aid/CPR certification. LPA Lindstrom reviewed the Guardian background check list and verified that all staff has a criminal record clearance. LPA Lindstrom requested all resident files. The review revealed that all required paperwork is present.

A tour of the facility was conducted. LPA Lindstrom then inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, laundry room, garage, storage areas, and back yard to ensure compliance with Title 22 regulations. The Administrator Certificate, Complaint Hotline Poster, Ombudsman information, menus, and resident personal rights are displayed in a central location.