Routine inspection·October 24, 2025

On October 09, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with Maria Gaston, Lead Staff. LPA returned to complete the annual on 10/24/2025. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. The facility is licensed for 20 Elderly Adults and is currently operating at a capacity of 15. Facility type, Elderly Adults (740). LPA Mixson toured the facility along with the Lead Staff, Juanita Gaston, and made observations pertaining to the annual visit. LPA inspected the facility inside and outside there were no obstructions or debris to the indoor or outdoor passageways at the time of this visit. Additionally, there were no bodies of water on the premises. The facility is a single-story multi building structure home located at 14295 Nason Moreno Valley CA 92555. Physical Plant: The facility phone number is (951) 601-9150 and it is operable. LPA Mixson observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations at. The bathrooms were clean, and appliances were operating appropriately at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something,” the "Personal Rights," and the PUB 475. The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care at the time of this visit. Medications : Were locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident. The overall facility is clean; the furniture is in good condition. The facility cooling system and other appliances were operable currently at the time of this visit. Administrator informed LPA there were safety lights for night throughout the facility. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. Care & Supervision / Administration: Adequate staff are present for the supervision of resident in care. Floor plans, telephone numbers and personal rights were found posted in the facility. The listed administrator possesses a current administrator’s certificate with an expiration date of 06/13/2026. Emely Rodriguez. Records Reviewed Resident Files: LPA reviewed the following forms in the residents files, admission agreements, medical assessments, consent forms, weight records, and emergency information. Appraisal and needs and services plan. Immunization records, along with the TB test. Records Reviewed Staff files: LPA requested and reviewed the following items for the staff records; First Aid, fingerprint clearances, abuse index, personnel records, health screenings, criminal record statements, employee rights, and TB test. Infection Control: LPA Mixson observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan and found all required infection control measures. There were no TA deficiencies observed or cited per Title 22, Division 6 of the California Code of Regulations at this time. An exit interview was conducted, and a copy of this report was discussed and given to Lead Staff, Juanita Gaston.