Golden Home for Seniors LLC IV

Type of visit: Prelicensing

On 1/15/2025, Licensing Program Analyst, Arvin Villanueva (LPA), arrived announced to conduct the pre-licensing inspection visit. LPA met with Licensee, Ma. Magnolia Tolon (S1) and Administrator, William Tolon (S2) and stated the purpose of the visit. Overview: Facility is a one-story home located in a residential neighborhood. Facility will be licensed to serve up to 6 elderly residents, up to 6 may be non-ambulatory. Facility does have fire clearance for one bedridden, in room #2. No clearance for delayed egress and locked exteriors. Physical Inspection: Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. Outdoor Area: Front yard was observed to be maintained and clear of debris and obstruction. The backyard equipped with outdoor furniture with umbrella. Outdoor passageways, walkways, driveways, and ramps are free from obstructions. Fence and gate are in good repair. No swimming pools/bodies of water at this time. There is a courtyard for resident use. Residents' Bedrooms: LPA inspected 6 of 6 resident bedrooms and were observed to be equipped with the required furniture and sufficient lighting throughout. Each bedroom is equipped with smoke detector. Each bedrooms is single occupancy. Room #2 is for bedridden. Each bedrooms have their own exits to the outside. Bedroom #3 of the facility sketch, the exit do not have a ramp. LPA observed the height difference from the door to the pavement is about 2 inches. (1 of 3) Bathroom: Facility has 3 resident bathrooms. Two of the bathrooms are in the hallway and the other bathroom is inside bedroom #5. Bathrooms have working toilets, wash basins and full baths with showers. Bathrooms are equipped with non-skid flooring and close-lid garbage bins. Linens & Hygiene Supplies: Adequate supply of linen and hygiene supplies stored in linen closet, located in the resident hallway. Emergency, Exit Plan & Menu: Emergency Disaster Plan will be posted & available for review. One fully charged fire extinguisher was observed at the entrance/foyer. The exit from the dining area going to the backyard did not have a ramp. LPA observed the height difference from the door to the pavement is about 2 inches. Dangerous Items: Sharp objects, toxins, and chemicals were locked/stored under kitchen sink and in the garage area. Water and room temperature: Hot water temperature was taken in one bathroom and measured at 112 degrees Fahrenheit. Room temperature was maintained at 73 to 74 degrees Fahrenheit throughout the visit. Food Service: Dishes, cups and flat ware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are in locked cabinet. Smoke Detectors and carbon monoxide: Smoke detectors were observed in each bedrooms and hallways. One carbon monoxide monitor were observed by the livingroom, at the hallway leading to the kitchen area. S1 tested one smoke detector and one carbon monoxide; both devices were working. Appliances: Stove burners and oven are in good working condition. Refrigerator/freezer temperature were within regulatory standard. Washer and dryer are located in the laundry room, leading to the garage area. Medications, First-Aid Kit & Records: First aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and manual which are stored in locked cabinet in the kitchen/dining area, available for staff use but inaccessible to residents. There is a medication cabinet that was observed to be locked in the kitchen area. (2 of 3) Residents & Staff Files: Applicant will not be handling cash resources of residents at this time but will submit necessary documents for any changes. Activity Supplies/Materials: LPA observed activity supplies stored in the kitchen/dining area. Advisory was provided for licensee to provide residents with a variety of activities and choices. Component III: S1 and S2 waived the Component III review since they completed one back in January 2025. At this time, the ramps were still in question. LPA contacted CAB analyst to request verification from the fire marshal regarding the ramps if they are needed or not. Once LPA have confirmation regarding the ramps, LPA will return at another date to continue the prelicensing inspection. An exit interview was conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jan 15, 2026