Senior Care Records.

Facility Evaluation Report

Mountain View Residence, Simi Valley02/11/2024Licence 561703268

Capacity4
Census4
Date signed02/11/2024 12:28:18 PM
The inspector’s account

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced for a required one-year annual inspection today. The last annual conducted at this facility was on 02/27/2023. When the LPA arrived, there was one (1) staff and three (3) residents present. The Licensee, Venis Caccam arrived at 9:15 a.m., and the reason for the visit was explained. The Administrator, Kirstie Caccam arrived during the inspection. Entrance interview conducted.

At 9:18 a.m., the LPA along with the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: The LPA inspected the kitchen/food service area at 9:32 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates and food labels had expiration date clearly marked. Cleaning solutions, knives, and sharps were observed locked and inaccessible under the kitchen sink. At 9:38 a.m., the hot water temperature measured at 119.8 degrees Fahrenheit.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. The fire extinguisher was observed to be in compliance and last charged on 04/27/2023. The LPA observed required postings throughout the common space. There is a working telephone on premises.

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