Senior Care Records.

Facility Evaluation Report

JJ Residential Care III, Simi Valley04/16/2025Licence 567609848

Capacity4
Census4
Date signed04/16/2025 12:34:31 PM
Name of licensing program analystErica Mosley
Name of licensing program managerKasandra Lopez
The inspector’s account

At 9:29 a.m. Licensing Program Analysts (LPAs) Erica Mosley and Quoc Huynh conducted a Case Management - Deficiencies visit due to a deficiency observed. The LPA’s advised the Administrator, Amelia Banas the reason for the inspection.

During the physical plant tour that started at 9:50a.m. the LPAs observed the shared, main bathroom shower to be non-operational. The facility has two (2) other working showers available for client use until the main shower is fixed. The Administrator stated that one of the clients broke the shower head on Sunday 04/13/2025 and will submit an SIR. A temporary fix was done on Sunday 04/13/2025 cutting the water supply to the shower along with calling a plumber. The Administrator states that the plumber has been scheduled since Monday 04/14/2025 and the repairs should be completed by Friday 04/18/2025. The Administrator was made aware of the potential health, safety, or personal rights risk to persons in care.

The following deficiency was observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and / or California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of the report and appeal rights were issued.

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