Facility Evaluation Report
Capacity6
Census11
Date signed10/21/2024 01:56:17 PM
On 10/21/2024 at 8:30 AM, Licensing Program Analysts (LPAs) James Sampair and Ardalan Gharachorloo conducted a Case Management visit of the facility.
The LPAs observed that residents R7 through R11 were living at this facility, though they are residents of Heart & Soul Communities #015601242.
1 Type-B citation issued during the inspection.
Deficiencies are cited per Title 22 California Code of Regulations as listed on the LIC 809-Ds. Failure to submit proof of corrections by plan of correction due dates may result in additional civil penalties.
Exit interview conducted, a copy of this report, and the appeal rights were provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction