Inspection Report
Annual Inspection
Capacity: 6
Deficiencies: 0
Nov 5, 2024
Visit Reason
The visit was an unannounced required comprehensive annual inspection of the facility.
Findings
The facility was found to be operating within the approved capacity and in safe, clean, and good repair conditions with no deficiencies cited. All required safety equipment and postings were present, and staff files were reviewed and found compliant.
Report Facts
Staff files reviewed: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Julinda Rodriguez | Facility Administrator | Met with Licensing Program Analysts during the inspection and was granted entry to the facility. |
| Paola Guerrero | Licensing Program Analyst | Conducted the inspection and signed the report. |
| Efren Malagon | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 2
Capacity: 6
Deficiencies: 0
Nov 8, 2023
Visit Reason
The visit was an unannounced required comprehensive annual inspection of the Residential Care Facility for Elderly (RCFE).
Findings
The facility was found to be operating within approved capacity and in good repair with no obstructions, adequate safety measures, and sufficient staffing. No deficiencies were cited during the inspection.
Report Facts
Residents present: 2
Licensed capacity: 6
Staff present: 1
Water temperature: 108
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Julinda Rodriguez | Facility Administrator | Met with Licensing Program Analyst during inspection and participated in exit interview |
| Paola Guerrero | Licensing Program Analyst | Conducted the unannounced annual inspection |
| Efren Malagon | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 2
Capacity: 6
Deficiencies: 1
Nov 8, 2022
Visit Reason
The visit was an unannounced required annual inspection with an emphasis on infection control due to the COVID-19 pandemic.
Findings
The facility has an adequate COVID-19 infection control plan and supplies, but a deficiency was issued due to items blocking the water heater posing a potential health and safety risk. The facility also has two additional rooms added with permits, and follow-up with the fire department is planned to ensure updated fire clearance.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| The licensee failed to keep walkways from the garage clear which poses a potential health, safety or personal rights risk to persons in care. | Type B |
Report Facts
Deficiencies cited: 1
Plan of Correction Due Date: POC due date is 2022-11-22
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Julinda Rodriguez | Facility Administrator | Met with Licensing Program Analyst and Manager during inspection. |
| Paola Guerrero | Licensing Program Analyst | Conducted inspection and signed report. |
| Efren Malagon | License Program Manager | Conducted inspection and signed report. |
| Sherly Mandagi | Facility administrator who toured the facility with LPA. |
Inspection Report
Annual Inspection
Census: 1
Capacity: 6
Deficiencies: 0
Nov 3, 2021
Visit Reason
Licensing Program Analyst Melody Brown made an unannounced visit to conduct an annual inspection with emphasis on infection control.
Findings
The facility was observed to have proper infection control measures including screening areas, signage, hand hygiene supplies, PPE, and trained staff. No deficiencies were cited during the inspection.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Julinda Rodriguez | Administrator | Greeted Licensing Program Analyst and accompanied on facility tour. |
| Melody Brown | Licensing Program Analyst | Conducted the annual inspection visit. |
| Efren Malagon | Licensing Program Manager | Named in report header. |
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