Senior Care Records.

Facility Evaluation Report

Simi Valley Residential Care III, Simi Valley09/30/2025Licence 565800113

Capacity6
Census6
Date signed09/30/2025 02:45:51 PM
Name of licensing program analystBrian Balisi
Name of licensing program managerDesaree Perera
The inspector’s account

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with Administrator Maria Mendez and explained the reason for the visit. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

LPA inspected the kitchen/food service area at approx. 10:15 a.m. Knives and sharp objects are stored underneath the sink in a locked box. Cabinet was locked and inaccessible to residents in care. Kitchen appliances were observed to be in operable condition. At approx 10:17 a.m. LPA observed staff preparing food. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. Office area located near entry way to the backyard. LPA observed facility files securely stored in this area.

At the time of the visit, the common area furniture's were observed to be in good condition. A variety of activities were observed stored in the living room. A sufficient supply of clean linen and towels were observed stored in two (2) hallway closets. The facility maintained a comfortable temperature of 71 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit.

The LPA observed six (6) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit. At approx. 10:27am, LPA observed staff interacting with residents. The staff room located next to the living room was observed to be inaccessible to residents in care and empty during the time of the visit.

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