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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 277209262
Report Date: 02/02/2026
Date Signed: 02/03/2026 10:57:49 AM

Document Has Been Signed on 02/03/2026 10:57 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:LOVING HEART MANORFACILITY NUMBER:
277209262
ADMINISTRATOR/
DIRECTOR:		ESTAMO, JUANITO JR.FACILITY TYPE:
740
ADDRESS:745 CARMELITA DRIVETELEPHONE:
(831) 758-8121
CITY:SALINASSTATE: CAZIP CODE:
93901
CAPACITY: 6CENSUS: 4DATE:
02/02/2026
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee Juanito Estamo, and Assistant Administrator Maria Estamo TIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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An Informal Office Meeting was conducted on this date at the Regional Office to discuss concerns that were observed during the Annual Inspection on 10/31/2025. Present during the meeting were:

See Moua, Licensing Program Manager
Sarah Hurt, Licensing Program Analyst
Juanito Estamo. Licensee
Maria Estamo, Assistant Administrator

The following issues were discussed and deficiencies are cited on the attached 809-D page:

- Criminal Record Clearance: 87355(e)(2) - Obtain a California clearance or a criminal record exemption as required by the Department…Staff 1 was not fingerprint cleared. Civil penalty was also assessed.
NAME OF LICENSING PROGRAM MANAGER: Brenda Chan
NAME OF LICENSING PROGRAM ANALYST: Sarah Hurt
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: LOVING HEART MANOR
FACILITY NUMBER: 277209262
VISIT DATE: 02/02/2026
NARRATIVE
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- Incidental Medical and Dental Care: 87465(h)(6) - The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained…R5’s medications was not listed on the Centrally Stored Medication Records
- Fire Clearance: 87202(a) - All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal…Resident 2 is bedridden and this facility does not have fire clearance for bedridden residents.
- Storage Space and Access: 87309(a)-…the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage…Toxins and cleaning supplies accessible to residents in hallway bathroom.
- Resident Records: 87506(a) - The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. Resident 1 does not have annually updated Needs and Services plan. Resident 3 does not have a Needs and Services Plan, admission assessment, TB test or required consent forms.
NAME OF LICENSING PROGRAM MANAGER: Brenda Chan
NAME OF LICENSING PROGRAM ANALYST: Sarah Hurt
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: LOVING HEART MANOR
FACILITY NUMBER: 277209262
VISIT DATE: 02/02/2026
NARRATIVE
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- Reporting Requirements: 87211(a)(1) - Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below…Licensee did not notify Licensing of residents being admitted to hospice care. Resident 4 passed away on August 19,2025. The facility did not notify Licensing of the resident’s passing.

The following concerns were also discussed:
- Facility does not have required disaster drills
- Hospice binders do not have required staff training
- Staff 2 does not have required TB test
- Facility Emergency Disaster Plan
- Current/updated resident roster

The licensee agrees to increased facility monitoring, and completing Licensing Technical Support Program.


Exit interview conducted with Juanito Estamo, and Maria Estamo. Appeals rights were given.
NAME OF LICENSING PROGRAM MANAGER: Brenda Chan
NAME OF LICENSING PROGRAM ANALYST: Sarah Hurt
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/03/2026 10:57 AM - It Cannot Be Edited


Created By: Sarah Hurt On 02/02/2026 at 09:06 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: LOVING HEART MANOR
FACILITY NUMBER: 277209262

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/03/2026
Section Cited
CCR
87355(e)(2)

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- Criminal Record Clearance: 87355(e)(2) - Obtain a California clearance or a criminal record exemption as required by the Department…The following requirement has not been met as evidenced by:
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staff 1 is confirmed to be fingerprint cleared.
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Staff 1 was not fingerprint cleared. which poses an immediate, heatlh, safety, or personal rights risk to residents in care. Civil penalty was also assessed
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Type A
02/03/2026
Section Cited
CCR87465(h)(6)

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- Incidental Medical and Dental Care: 87465(h)(6) - The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained…The following requirement has not been met as evidenced by:
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Licensee will submit staff training on the subject of documenting Centrally Stored medications and submit to LPC by POC date of 02/03/2026.
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R5’s medications was not listed on the Centrally Stored Medication Records, which poses an immediate, health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brenda Chan
NAME OF LICENSING PROGRAM MANAGER:
Sarah Hurt
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2026


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 02/03/2026 10:57 AM - It Cannot Be Edited


Created By: Sarah Hurt On 02/02/2026 at 09:29 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: LOVING HEART MANOR
FACILITY NUMBER: 277209262

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/03/2026
Section Cited
CCR
87202(a)

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- Fire Clearance: 87202(a) - All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal…The following requirememt has not been met as evidenced by:
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Licensee will submit required documents to allow care of bedridden residents to LPA by POC date of 02/03/2026.
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Resident 2 is bedridden and this facility does not have fire clearance for bedridden residents, which poses an immediate health, safety, or personal rights risk to residents in care.
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Type A
02/03/2026
Section Cited
CCR87878

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- Storage Space and Access: 87309(a)-…the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage…The following requirement has not been met as evidenced by:
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Licensee will submit staff training on proper storage of chemicals to LPA by POC date of 02/03/2026.
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Toxins and cleaning supplies accessible to residents in hallway bathroom., which poses an immediate health safety or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brenda Chan
NAME OF LICENSING PROGRAM MANAGER:
Sarah Hurt
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/03/2026 10:57 AM - It Cannot Be Edited


Created By: Sarah Hurt On 02/02/2026 at 09:35 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: LOVING HEART MANOR
FACILITY NUMBER: 277209262

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2026
Section Cited
CCR
87506(a)

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- Resident Records: 87506(a) - The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. The following requirement has not been met as evidenced by:
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Licensee will complete TSP training and will ensure resident and staff records are updated.
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 Resident 1 does not have annually updated Needs and Services plan. Resident 3 does not have a Needs and Services Plan, admission assessment, TB test or required consent forms, which poses a potential, health, safety, or personal rights risk to residents in care.
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Type B
02/16/2026
Section Cited
CCR87211(a)(1)

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- Reporting Requirements: 87211(a)(1) - Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below…The following requirement has not been met as evidenced by:
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Licensee will complete TSP training and will ensure resident and staff records are updated
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Licensee did not notify Licensing of residents being admitted to hospice care. Resident 4 passed away on August 19,2025. The facility did not notify Licensing of the resident’s passing, which poses a potential, health, safety, or personal rights risk to residents in care/
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brenda Chan
NAME OF LICENSING PROGRAM MANAGER:
Sarah Hurt
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2026


LIC809 (FAS) - (06/04)
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