Facility Evaluation Report

On 5/8/2025 at 12:00pm, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a Case Management visit. LPA met with Jake Lapuz, Caregiver, and explained the reason for the visit. Administrator, Shahid Siddigui, arrived at 1:20pm.

While LPA L. Hall was conducting a collateral visit at the facility on 5/8/2025. LPA observed during record review S1 was not associated to the facility. LPA observed facility was cited for same staff on 1/24/2025, for not being associated.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. A copy of the appeal rights and this report and appeal rights provided