Facility Evaluation Report
Capacity6
Census5
Date signed04/11/2025 08:01:04 AM
Name of licensing program analystTonica Syess-Gibson
Name of licensing program managerHarpreet Humpal
On 04/10/2025 at 01:20PM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted a Component III Review, for the Pre-licensing Inspection which was conducted on this date.
LPA reviewed Component III with Administrator Kavitha Pramod.
A license has not yet been granted to this facility. Licensure is subject to final review and approval by the Centralized Applications Unit.
See LIC809 (Pre-licensing Inspection) Report dated 04/10/2025, for the Pre-licensing Inspection conducted in relation to this report
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction