Senior Care Records.

Facility Evaluation Report

Elim Place, Sanger02/12/2026Licence 107209543

Capacity44
Census31
Date signed02/12/2026 02:22:20 PM
Name of licensing program analystKamaldeep Kaur
Name of licensing program managerSee Moua
The inspector’s account

Licensing Program Analyst LPA K.Kaur conducted Case Management visit and was allowed entry by staff. LPA met with Administrator/ Executive Director Maria Ceballos. LPA discussed the purpose of the visit.

Case Management Visit is regarding an incident report received in the Regional Office on 02/06/2026. The incident occurred on 01/31/26, during which R1 was given a double dosage of the same medication.

Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22,

An exit interview was conducted with Administrator including discussing the plan of corrections. Report signed on-site. A copy of this report and appeal rights were provided to Administrator, whose signature on this form confirms receipt of this document.

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