Facility Evaluation Report
Capacity6
Census4
Date signed08/29/2025 04:09:10 PM
Name of licensing program analystNune Margaryan
Name of licensing program managerWei Siew Ho
This case management visit is conducted in conjunction with complaint investigation to address the deficiencies unrelated to the complaint.
During complaint investigation LPA observed that Staff 1 (S1) has a criminal record clearance but not associated to the facility.
Therefore, the following citation was issued and recorded on LIC809D. Immediate Civil Penalties Assessed.
An exit interview was conducted with the Administrator, and a copy of this report was provided along with the Appeals Rights.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction