Facility Evaluation Report
On 5/8/2026 at 2:00PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit. LPA met with Caregiver, Jocelyn Canlas and explained the purpose for the visit. Administrator, Madeena Siddiqi was not able to be at the facility and designated caregiver to sign licensing reports.
While LPA G. Luk was at the facility for a complaint investigation (#15-AS-20260107142423), the following deficiencies were observed.
LPA observed unlocked medications on the dining room table.
LPA observed on Guardian system that S1 was not associated to the facility, but had fingerprint clearance. LPA observed on Guardian system that S2 determination status was "In Process".
During complaint investigation, LPA observed facility did not submit incident report to CCLD when R1 was sent to the hospital on 12/6/2025.
The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency may result in civil penalties.
Exit interview conducted. A copy of this report, civil penalty, and appeal rights provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction