Facility Evaluation Report
Capacity6
Census2
Date signed07/31/2025 03:07:39 PM
Name of licensing program analystKelly Nguyen
Name of licensing program managerBennett Fong
On 07/31/2025 at 2:00 PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a POC visit. LPA spoke with Administrator (ADM) Victoria Puruganan and explained the purpose of the visit via phone. ADM gave verbal permission for the Care staff, Renato L. Tisico, to sign the report.
The administrator failed to provide POC during the POC visit.
***An immediate $200.00 civil penalty will be assessed on today's date for failure to correct ***
Exit interview conducted. A copy of the LIC421FC, this report, and appeal rights are provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction