374602902-3-16-2026-08-AS-MGCO-DS8VN5-20260316163434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374602902
Report Date: 03/16/2026
Date Signed: 03/16/2026 04:35:24 PM

Document Has Been Signed on 03/16/2026 04:35 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	LYN'S HOME CARE III		FACILITY NUMBER:	374602902
ADMINISTRATOR/ DIRECTOR:	ABILLE, LYDIA		FACILITY TYPE:	735
ADDRESS:	186 MOSS ST		TELEPHONE:	(619) 426-2804
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91911
CAPACITY: 6		CENSUS: 6	DATE:	03/16/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:15 PM
MET WITH:	Licensee Lydia "Lyn" Abille		TIME VISIT/ INSPECTION COMPLETED:	04:35 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) Marisela Garcia-Centeno conducted an unannounced visit to continue a Required Annual Inspection that began on 03/21/2025. LPA was welcomed by and identified himself to Licensee Lydia “Lyn” Abille and discussed the purpose of the visit. According to the facility’s license, the facility has a maximum capacity of six (6) clients, all of whom must be ambulatory. Based on LIC 602 Physician’s Reports, staff interviews, and LPA observations, there were six (6) clients in care at the time of the inspection, and all were ambulatory per their respective physicians. The facility’s license does not include endorsements for delayed-egress doors or a secured perimeter, and neither were observed during the inspection. During the visit, LPA toured the interior and exterior of the facility and inspected all common areas and bedrooms. LPA interviewed multiple clients and staff and reviewed care and administrative records for all clients, as well as personnel and training files for all active staff. The facility was in generally good repair; however, some areas were observed to be unclean. Pathways were free of obstructions and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were observed to be operational. Some bedrooms were observed to be messy, with dirty clothing and trash present. These observations were addressed through Technical Assistance (TA). (continue at LIC809C)

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026

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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: LYN'S HOME CARE III	FACILITY NUMBER: 374602902
	VISIT DATE: 03/16/2026

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(Continue from LIC809)

Extra linens, hygiene supplies, and Personal Protective Equipment (PPE) were available. The facility had sufficient space and equipment to accommodate dining, laundry, visitation, meetings, and client activities. The refrigerator and freezer temperatures were within regulatory ranges. The facility maintained at least two (2) days of perishable food and seven (7) days of non-perishable food, all properly stored. Cooking and dining equipment were present. No sharp objects, toxic chemicals, fireplaces, or open-faced heaters were accessible to clients.

No pools or bodies of water were observed on the premises. The facility fireplace was properly screened. Smoke detectors, carbon monoxide detectors, emergency lighting, night lights, and the facility telephone were observed to be operational. Confidential records were stored in locked areas. Required licensing postings were displayed in visible areas of the facility. According to the Licensee, no firearms or ammunition are kept on the premises. The Licensee provided proof of current business liability insurance and a surety bond.

Medications were properly labeled and stored in locked areas. Resident and staff records containing confidential information were secured. Fire extinguishers were serviced within the last 12 months, with the most recent service completed on October 12, 2025. The first aid kit was complete and accessible. Emergency drills were conducted as required.
LPA interviewed staff and clients and reviewed staff and client files. No licensing concerns were identified through interviews. Client files contained required documentation, and staff files included proof of current first aid training.

No deficiencies were cited during today’s visit.

An exit interview was conducted with Licensee Lydia Abille. A copy of this report and the Licensee/Appeal Rights (LIC 9058 03/22) were provided during today’s visit.

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026

LIC809 (FAS) - (06/04)

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