St. Peter Residence

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Jay Tayap. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Four (4) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Employee records review began- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current 11/20/2026, Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 115.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the designated area. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. (Continued on LIC809-C, Page 2) (Continued from LIC809, Page 1) Food Service- Food supply meets the of one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observations throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 06/2/2026. The facility conducting emergency disaster drills monthly. Corporation is active and in good standing. Based on the information received during this visit today, there are zero (0) deficiency is being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with Bene Molintas, and a copy was provided at the time of the exit interview.the state’s words, verbatim · CDSS document, Aug 12, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Seo Jeon conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. LPA met with Applicant, Restituto Calilung. An initial application to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 03/20/2025 for a total capacity of six, (5) non-ambulatory and one (1) bedridden resident. Fire clearance was granted on 05/06/2025. LPA Seo Jeon observed the following: Structure: Facility was a one-story house with five (5) resident bedrooms, five (5) resident bathrooms, living room, dining area and kitchen. There is no swimming pool or known fire arms in the premises. Heating/Cooling System: Central heating and air conditioning system installed with a central panel located in the hallway to control entire house. Bedrooms: Each resident bedroom #2, #3, #4, and # 5 will accommodate any non-ambulatory resident, and bedroom #1 will accommodate bedridden resident. 5 resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, and an operable smoke alarm. Continued on LIC809-C..... Bathrooms: Five (5) resident bathrooms have a working toilet, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. LPA tested the water temperatures in the resident bathrooms. LPA verified water temperature was measured at 120 degrees Fahrenheit. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the kitchen. There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator/freezer were in working condition and had sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry room with washer and dryer was located in the back of the facility. Laundry detergents and cleaning supplies were observed in laundry room secured in a locked entry door away from residents. Living/Family room: There was a living/family room with adequate seating for all clients and TV. Linens and Hygiene Supplies: An adequate supply of linens was stored in a cabinet in the main hallway of the residence. Yards/Outside: There is patio with furniture for outdoor seating. There was a gate on the right side and left side of the property with a self-latching doors. There were no debris in the backyard. Emergency Phone Numbers, and Exit Plan: Facility sketch was observed to be posted near the entrance and each resident bedroom. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA has determined that the facility met the operational requirements for licensure. The Pre-licensing inspection is complete. The facility has satisfied all requirements in accordance with Title 22 California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Applicant.the state’s words, verbatim · CDSS document, Jul 9, 2025