Victoria Caring Home

Type of visit: Required - 1 Year

On June 16, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator Maria Priscilla Mirabueno was not available to assist with the facility inspection. House Manager Eliseo Manuel assisted with today’s visit and notified Administrator Mirabueno via telephone. The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for six (6) residents. Currently, there is one (1) Hospice resident present during today’s visit. This is a single story home with a attached garage facility. The facility has four bedrooms (two shared resident rooms, two private resident rooms), dining room, living room, kitchen and two bathrooms LPA conducted a tour of the physical plant accompanied by House Manager Manuel, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 105.5 degrees F. A comfortable temperature of 75 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning chemicals and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient two day perishable and Seven day non-perishable food was maintained adequately. Facility had supply of emergency food and water. Facility has one fire extinguisher which was mounted and fully charged . CONTINUED ON 809C During the visit, LPA observed screening protocols for visitors, staff and sanitizing stations in common areas and restrooms. LPA observed the facility has supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The last fire drill was conducted on May 6, 2026. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. Facility has audible alarms on exits. The facility has current liability insurance on file effective 6/23/2026 – 6/23/2027. A review of five residents (R1-R5) service files and two staff (S1-S2) personnel files revealed to be complete. The facility has the current administrator's certification on file for Maria Priscilla Mirabueno # 7012741740 - Expiration 11/01/2026. No deficiencies during this inspection visit. An exit interview was conducted with House Manager Eliseo Manuel and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual inspection of the facility. Upon arrival, LPA Haddadin was greeted by care staff Eliseo Mannuel, who granted entry and was informed of the purpose of the visit. LPA toured both the interior and exterior of the facility and made the following observations. The facility is licensed to operate for six (6) non-ambulatory residents and has an approved hospice waiver for six (6) residents. It is a single-story structure located in a residential neighborhood and consists of four (4) resident bedrooms, two (2) bathrooms, a living room, dining room, kitchen, attached two-car garage, and an outdoor covered patio. At the time of the inspection, five residents were in care. All resident bedrooms were inspected and observed to be appropriately furnished with a bed, chair, and clean linens, with adequate storage available. The rooms were free of tripping hazards. The kitchen was in good repair, with all major appliances operational. However, sharps and knives were not secured and were accessible to residents. In addition, chemical supplies were accessible underneath the kitchen sink and in the cabinet beneath the sink located in Bathroom 1. The exterior of the facility was well maintained. Furnishings were in good repair, pathways were unobstructed and free of hazards, and the grounds appeared safe and welcoming, with a shaded seating area available {***CONTINUE 809C***}. The fire extinguisher was fully charged, with the indicator in the green zone, and the most recent inspection date recorded was September 19, 2025. Hot water temperature was measured at 116.6 degrees Fahrenheit, which falls within the regulatory requirement. A review of records revealed that the last emergency drill was not conducted in accordance with regulation, as documentation showed the most recent drill took place on June 6, 2024. The facility maintained sufficient food supplies, including at least a two-day supply of perishable items and a seven-day supply of nonperishable items. A review of resident files revealed no discrepancies. Staff files were complete and contained all required documentation. Based on today’s inspection and observations, deficiencies are being cited in accordance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, along with appeal rights, was provided to the staff on duty.the state’s words, verbatim · CDSS document, Sep 20, 2025

Type of visit: Required - 1 Year

On June 17, 2024 at 10:30am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator Maria Mirabueno and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory and have a hospice waiver for six (6) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, two (2) bathrooms, living room, dining room, kitchen, attached 2-car garage, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant. There are no bodies of water or obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 111.2 degrees F and 111.5 degrees F. A comfortable temperature of degrees 77 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, water, and supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged and was serviced on September 1, 2023, and smoke detectors/carbon monoxide detectors were operable. The facility conducted Fire/Safety Drill on June 4, 2024 and does it quarterly. A working telephone (714-952-9242) remains available. First Aid Kit contained all the necessary elements. Evaluation Report Continues on LIC 809-C During the visit, LPs\A Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA conducted an audit of resident files (R1-R6), staff files (S1-S4), and medication and medication administration review. LPA Kim conducted resident interviews and staff interviews. A deficiency was cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of this report was provided to Administrator Maria Mirabueno.the state’s words, verbatim · CDSS document, Jun 17, 2024