Facility Evaluation Report
Capacity5
Census4
Date signed08/08/2025 04:01:37 PM
Name of licensing program analystJimmy Duarte
Name of licensing program managerSerigy Pidgirny
During an announced annual inspection, Licensing Program Analyst (LPA) J. Duarte, discovered staff members (S1 and S2) were not associated to the facility. Administrative Assistant Crystianna Robynson associated both staff to the facility during the visit.
A deficiency is being cited per California Code of Regulations, Title 22. A civil penalty is being assessed for the amount of $100 ($100 per day x 1 day = $100) per staff (S1 and S2) for working at the facility without clearance transfer.
This report and LIC 421BG were reviewed with Claudia Yvonne Ramirez and a copy of the reports and appeal rights were provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction