<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603970
Report Date: 08/03/2026
Date Signed: 08/03/2026 03:24:02 PM

Document Has Been Signed on 08/03/2026 03:24 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:FAIRVILLA HOME CAREFACILITY NUMBER:
198603970
ADMINISTRATOR/
DIRECTOR:
CALMA, RHODAFACILITY TYPE:
740
ADDRESS:14778 FAIRVILLA DRTELEPHONE:
(562) 228-4439
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY: 6CENSUS: 2DATE:
08/03/2026
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Rhoda Calma, TIME VISIT/
INSPECTION COMPLETED:
03:25 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
Licensing Program Analyst (LPA) Galarza arrived unannounced to conduct an Post Licensing inspection. The purpose of the visit was explained to Administrator Rhoda Calma. was contacted telephonically. The facility is licensed for six (6) non- ambulatory elderly residents ages 59 and over.

Observations & Record Review:


  • LPA toured and inspected the facility. It consists of six (6) private resident bedrooms, one live-in staff room, kitchen, dining room, living room, attached garage with laundry room, and backyard. Sharps were observed locked and inaccessible to residents in care. No obstructions were noted in hallways or living areas. Sufficient furniture and lighting was observed throughout the facility.

  • Resident files were reviewed. No resident are currently enrolled in hospice.

  • Centrally stored medications were observed locked and inaccessible to residents.

  • The facility has a posted Residential Care Facility for the Elderly (RCFE) Complaint Poster.

No deficiencies or health and safety concerns were observed.

The report was reviewed with Administrator. A copy of the report was issued.
Lisa Hicks
Noemi Galarza
DATE: 08/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 3 of 3