Facility Evaluation Report
Capacity6
Census4
Date signed12/17/2025 11:07:23 AM
Name of licensing program analystFelisa Shirley
Name of licensing program managerStephanie Cifuentes
On 12/17/25, LPA Felisa Shirley went to conduct a case management for the death of C-1, F, 64 at Dalton Care Home.
LPA Shirley, reviewed C-1’s facility file, Special Incident Report dated 12/9/25, C-1’s Death Report and requested copies of the following: facesheet, Identification and Emergency Information, IPP report, physician’s report, and discharge instructions for 12/9/25 visit. LPA Shirley spoke with S-1 and with the Administrator, Mariel Ventura.
Administrator stated that client C-1 came to this facility 8/29/23.
Copy of this report is being signed by the Administrator, Mariel Ventura.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction