Facility Evaluation Report
Capacity40
Census27
Date signed08/06/2025 01:19:02 PM
Name of licensing program analystMai Yang
Name of licensing program managerSee Moua
On 08/06/25, Licensing Program Analyst (LPA) M. Yang arrived at the facility unannounced to continue Annual Inspection. LPA met with Administrator Douglas Rice.
A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6.
Exit Interview conducted. The following documents are requested to be submitted to the department by
08/12/25: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights was provided to Administrator, whose signature on this form confirms receipt of the report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction