Facility Evaluation Report
Capacity6
Census6
Date signed11/04/2025 03:06:41 PM
Name of licensing program analystMelinda Medina
Name of licensing program managerSergiy Pidgirny
On 11/04/2025, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Continuation visit to facility. LPAs introduced self, stated purpose of visit and allowed entrance by Direct Care Staff. LPA met with House Manager, Margaret Gardea to conduct visit.
LPAs reviewed a sample of staff files and resident files, files reviewed and observed to have the required documentation. LPAs interviewed staff and resident. Inspection tool completed.
Exit interview conducted with Administrator. A copy of this report was provided at the time of visit.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction