Senior Care Records.

Facility Evaluation Report

Cypress House, Oakley07/23/2025Licence 079200856

Capacity4
Census2
Date signed07/23/2025 05:34:57 PM
Name of licensing program analystTonica Syess-Gibson
Name of licensing program managerHarpreet Humpal
The inspector’s account

On 07/23/2025 at 3:36 PM, Licensing Program Analyst (LPA) T Syess-Gibson conducted a case management as a result of observations made during complaint visit 15-AS-20250717163102. LPA met with Jesse Mendenhall, Program Administrator, and explained the purpose of the visit.

At 3:28PM, LPA observed staff (S1) is not associated with the facility via guardian

LPA asked S1 to leave the facility, okay to return when S1 is associated to facility.

***A civil penalty in the amount of $500 was assessed on today’s date***

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.

Exit interview conducted. A copy of the appeal rights, LIC421BG, and this report provide .

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction