Senior Care Records.

Facility Evaluation Report

Mom's Place I, Camarillo05/19/2025Licence 565850346

Capacity6
Census4
Date signed05/19/2025 06:52:19 PM
Name of licensing program analystValeria Conway
Name of licensing program managerDesaree Perera
The inspector’s account

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 10:15 A.M. The LPA was greeted by Caregiver Romeo Thompson. LPA informed the reason for the visit. Caregiver contacted the facility representative by phone, Laila Kulungu. At 10:55 A.M. facility representative arrived. Administrator, Yusuf Ibironke, was unavailable during today's visit and does not come to the facility often due to distance, however, authorized facility representative, to sign today's reports. Reason for the visit was stated. Entrance interview conducted.

At 11:10 A.M. LPA conducted a physical plant tour inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Fire extinguisher was last purchased 04/16/2025. Between 11:32 A.M. and 11:39 A.M. two (2) carbon monoxide detectors and the hardwired smoke detectors were tested and functioned properly. According to facility representative, the door connecting the common area to the wing where rooms one (1) through four (4) are located is designated as a fire door. This door is in place to enhance safety and prevent the spread of fire.

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