Facility Evaluation Report
Capacity6
Census3
Date signed08/25/2025 02:00:40 PM
Name of licensing program analystKelly Nguyen
Name of licensing program managerBennett Fong
On 8/25/2025 at 12:20 pm, Licensing Program Analysts (LPAs) K. Nguyen and P. Manalo conducted an unannounced Case Management visit requesting documents from the facility. LPAs met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report.
LPAs requested for complete resident(R) files of R1, R2, R3, R4, and R5. ADM will submit documents by 8/29/25.
An exit interview is conducted copy of this report is provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction