Matsonia Lane Homes

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Catalina Mones after introducing and stating the reason for the visit. Administrator (Admin) Mylene Gabat arrived on premise and remained for the duration of the visit. Admin Mylene Gabat has a valid certificate expiring on November 19, 2026. The following was observed during the inspection: This is a single story property located in a residential neighborhood comprised of five private resident bedrooms and two resident bathrooms. Facility is operating within the conditions and limitations specified on the license. LPA observed four residents in care with one resident hospitalized, and one of which is receiving hospice service. LPA toured the interior portion of the facility. The facility is clean and in good repair. All common areas were inspected including the attached two car garage also utilized as an office. LPA inspected all resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be in compliance, clean, and operational. Slip resistant mats were available. The hot water temperature in the bathrooms measured at 116.4 and 116.6 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food. The exit gate is operational, and there were sufficient seating and shading in the patio area. There is a secured pool in the backyard inaccessible through a gate. The first aid kit contains all necessary elements. The fire extinguisher was mounted, charged, and purchased on March 23, 2026. The auditory devices and smoke/carbon monoxide detectors were tested and operational. Facility maintains emergency food and water. The facility land line number, (714) 965-2710, was tested and remains available. Complaint Poster, 'See Something, Say Something,' (PUB 475) was available and posted in the correct size. LPA reviewed five of five resident and two of two personnel files in which no discrepancies were found. Medications were audited for three of five residents. No discrepancies found with medication administration. However, staff were reminded to maintain an accurate record of dosages administered. Present staff are background cleared and associated to facility. Staff training is up-to-date. Disaster drills are conducted quarterly as last known drill was conducted on February 4, 2026. LPA consulted on the following: to maintain an accurate record of medications administered as three medications for (1) day was not documented as given which was verified per the pill count. Admin stated that a medication in-service will be provided. Admin expressed an interest in possibly converting the living room to a resident bedroom. Guidance on the Department's requirements were discussed. Based on the observations made during today's visit, no deficiency is being cited, however a Technical Violation is being issued. An exit interview was conducted with Administrator Mylene Gabat, and a copy of this report was provided at the end of the visit.the state’s words, verbatim · CDSS document, Mar 23, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA Haley was greeted and granted entry by staff who contacted Licensee/Administrator (AD) Maylene Gabat who was unable to attend the visit. AD Maylene has a current Administrators certificate that expires November 19, 2026. Matsonia Lane Homes is a one-story community with five bedrooms and two bathrooms. The current capacity is 3 and the census was 2 during the visit. During the inspection, LPA Haley observed all resident bedrooms. The bedrooms had all the requirements and were in compliance with regulation guidelines. In the hallway near the main bathroom, LPA Haley observed incontinent care supplies. A Carbon monoxide detector was observed in the hallway and tested operational. In a hallway closet right cross from the kitchen there is a closet with a nonperishable food supply. Resident bathrooms were observed. Hot water temperatures were measured in between 111.2 degrees Fahrenheit and 111.5 degrees Fahrenheit. No hazardous items were observed in the resident bathrooms. In the kitchen LPA observed a perishable food supply in compliance with regulation requirements. Knives and sharp objects are kept locked in a drawer near the sink. No hazardous cleaning chemicals are stored in the garage. The stove was being used to prepare lunch for the residents and two of the burners were in good working order. However, after staff finished cooking and the other two burners were checked, the top left burner was observed to be non-operational. A first aid kit with all the required elements was observed in a drawer in the dining room. The fire extinguisher was fully charged and mounted on the wall in the kitchen/dining room next to the refrigerator. Resident files are kept in a locked file cabinet in the dining room. In the same locked cabinet are emergency bags for each resident, an emergency water supply, and resident medications. Continued on LIC809C In the garage, LPA Haley observed a laundry area with a washer and dryer, a locked cabinet with all the hazardous cleaning chemicals, an office area, and filing cabinets with staff files and other facility files. There’s an additional refrigerator with an additional food supply and refrigerated medication for one of the residents. The backyard was clean and organized. No tripping hazards were observed. There is a swimming pool in the backyard surrounded by a self-latching gate that measured 5 feet off the ground at the entrance of the gate. Smoke detectors were observed in all resident rooms and the hallway, all of which tested operational. Emergency drills have not been conducted. 2 staff files, 2 resident files, and 3 resident medications were reviewed during the inspection. Deficiencies are being cited as a result of today’s visit. An exit interview conducted and a copy of this report, and appeal rights was provided to staff.the state’s words, verbatim · CDSS document, Mar 21, 2025

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.