374604492-3-2-2026-18-AS-KWEN-DRSUHB-20260302143542

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604492
Report Date: 03/02/2026
Date Signed: 03/02/2026 02:36:00 PM

Document Has Been Signed on 03/02/2026 02:36 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	DIAMOND CARE RCFE		FACILITY NUMBER:	374604492
ADMINISTRATOR/ DIRECTOR:	MELTON, MARK ALLAN		FACILITY TYPE:	740
ADDRESS:	1784 FOOTHILL VIEW PL		TELEPHONE:	(760) 442-7507
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92026
CAPACITY: 6		CENSUS: 6	DATE:	03/02/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Administrator Mark Melton		TIME VISIT/ INSPECTION COMPLETED:	02:40 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 3/2/26, Licensing Program Analysts (LPAs) Kyle Wellington and Janette Romero made an unannounced visit to the facility to conduct an annual inspection. LPAs met with the Administrator, Mark Melton, who was informed of the purpose of the visit. LPAs observed 2 (two) staff and six (6) residents present at the facility. The census at the facility is six (6) residents with one (1) of the residents receiving hospice care. LPAs received a LIC 9020 from the Admin. LPAs toured the inside and outside of the facility with the Admin. LPAs conducted an observation, interviews and record review at the facility for the inspection. Facility Overview: The facility is a one story house with six (6) resident bedrooms, three (3) bathrooms, kitchen, family room, dining room, laundry room and attached garage. There are no pools, bodies of water or firearms at the facility. The facility has a fire clearance to serve five (5) non ambulatory and one (1) ambulatory residents. The facility has a hospice waiver for four (4) residents. Infection Control: LPAs observed soap dispensers in the bathrooms and hand sanitizers in the facility. Cleaning supplies were locked in the garage and available for regular facility maintenance. LPAs reviewed the facility’s infection control plan which met the department’s requirements. Physical Plant: LPAs observed the inside and outside of the facility to be clean, safe and well kept. The floors, windows and doors were clean and well maintained. The living room and dining room furniture was in good repair. The halls had night lights and were free of obstruction. The residents’ bedrooms were neat, organized and had the required bedding, furniture and lighting. Bathrooms were clean, tidy and contained handrails and non-slip mats in the shower. The hot water temperature in the bathroom was measured at 112

NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Kyle Wellington
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/02/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026

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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: DIAMOND CARE RCFE	FACILITY NUMBER: 374604492
	VISIT DATE: 03/02/2026

NARRATIVE

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F. Clean linens and towels were available in a hall closet. Laundry equipment appeared in good working condition. The one (1) fire extinguisher was charged and available for use. Admin tested one (1) of the smoke and carbon monoxide detectors and LPAs found them to be hard wired and operational. The backyard was clean, free of hazards and contained outdoor furniture & shaded area for the residents.

Kitchen/Food Service: LPAs observed the kitchen to be clean, organized, and well maintained. The kitchen had the ability to prepare and store food in a safe and clean environment. Kitchen equipment appeared to be in good working condition. Dishes, containers, pot/pans and silverware appeared clean and in good condition. All sharp and dangerous objects were kept in a locked drawer inaccessible to residents. Cleaning supplies were kept in a cabinet in the garage inaccessible to residents. The refrigerator/freezer was clean, stocked and at the required temperatures. Food in the refrigerator/freezer and cabinets/pantry/garage were stored properly and not expired. The facility has at least a two day supply of perishable foods and a seven day supply of non perishable foods.

Care & Supervision: LPAs observed the facility had sufficient staff present to supervise the residents.

Administration: LPAs observed personal rights information, facility sketch, emergency phone numbers, Ombudsman information and phone numbers and complaint procedures were posted near the front door. Admin holds a current Administrator Certificate and a current CPR Certification. Admin has a criminal record clearance.

Record Review and Resident/Staff Files: LPAs compared the staff present at the facility to the Guardian staff roster for criminal record clearance. LPAs reviewed the records of two (2) staff files and two (2) residents’ files. The files contained all the required documentation and paperwork. The staff and residents’ files were kept in a locked closet in the hall inaccessible to unauthorized individuals.

Health Related Services/Incidental Medical Services: LPAs observed all residents’ medications were locked in a closet in the hall inaccessible to residents. No medication was stored in a refrigerator with food items. LPA reviewed the facility’s medication administration record (MAR) to make sure all medication wasaccounted for and dispensed correctly. First Aid kit contained all the required items and was kept in a locked closet in the hall.

NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Kyle Wellington
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/02/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026

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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: DIAMOND CARE RCFE	FACILITY NUMBER: 374604492
	VISIT DATE: 03/02/2026

NARRATIVE

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Disaster Preparedness: LPAs reviewed the facility’s emergency and disaster plan. The plan was current and up to date. Safety and fire drills are conducted every three (3) months with the last drill occurring in 2/26. LPAs observed all facility exits were clear of obstructions and had the required signage.

No deficiencies were cited during this visit.

Exit interview was conducted with the Administrator and a copy of this report was given to the Administrator.

NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Kyle Wellington
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/02/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026

LIC809 (FAS) - (06/04)

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