Senior Care Records.

Facility Evaluation Report

Cherry Blossom Adult Care, INC., Hayward11/21/2024Licence 019201076

Capacity4
Census4
Date signed11/21/2024 02:09:32 PM
The inspector’s account

On 11/21/24 at 1:30PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management health & safety check and met Billy Leung, Co- License. Co-Licensee called and spoke with Ricky Ng Administrator (ADM) and informed the purpose of visit. ADM was not available to come and gave verbal permission for Billy to sign the report.

During the health and safety check, LPA observed no clients and one staff at facility. LPA toured facility with staff, including but not limited to bedrooms, kitchen, bathroom, and common areas. Clients in care appear to be safe and there are no imminent health/safety concerns on today's date.

No deficiencies cited during the health and safety check. Exit interview conducted and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction