Facility Evaluation Report
Capacity4
Census4
Date signed07/03/2025 12:16:41 PM
Name of licensing program analystMelinda Medina
Name of licensing program managerSergiy Pidgirny
On 7/03/2025 Licensing Program Analysts (LPAs) M. Medina and J. Duarte conducted an unannounced Case Management Annual Continuation visit. LPAs arrived, introduced self, and stated purpose of visit. LPAs met with Administrator, Carlos Chavez to conduct visit. .
Annual continuation visit is being conducted to complete items from previous visit on 6/30/2025. Case management visit was a continuation for staff file review, resident records review, and a completion of the care tool.
Exit interview conducted and facility report signed by Administrator and a copy provided for facility records.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction