Facility Evaluation Report
Capacity170
Census84
Date signed06/20/2025 08:13:27 AM
Name of licensing program analystMai Yang
Name of licensing program managerSee Moua
On 06/19/25, Licensing Program Analyst (LPA) M. Yang arrived to conduct an unannounced subsequent complaint investigation and met with Administrator Perla Pena. During the course of the investigation, LPA toured the facility, checked residents’ medications and reviewed residents’ MARs.
Deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6.
An exit interview was conducted. A copy of this report and appeal rights was provided to Administrator, whose signature on this form confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction