Facility Evaluation Report
Capacity6
Census2
Date signed04/12/2023 06:19:34 PM
On 04/12/23 Licensing Program Analyst( LPA) Ernand Dabuet initiated a Collateral visit at this facility. LPA met with Direct Support Provider Sayra Ramos . LPA explained the purpose of this visit is to gather information regarding a current complaint about ACOSTA FAMILY HOME II Complaint number 11-AS-20230406123315.
The investigation consisted of collecting service records for client #1-#2 (C1-C2). The following records were obtained:
Details of the record reviews are documented on LIC 812 crossed reference with Acosta Family Home II.
An exit interview was conducted with Sayra Ramos, and a hard copy was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction