Senior Care Records.

Facility Evaluation Report

Ayanna Home Care, Lakewood12/19/2025Licence 198603457

Capacity6
Census5
Date signed12/19/2025 03:08:32 PM
Name of licensing program analystChristian Gutierrez
Name of licensing program managerDavid Sicairos
The inspector’s account

Licensing Program Analyst (LPA) Christian Gutierrez generated this Case Management - Deficiencies report in conjunction with complaint control 28-AS-20251114111409 pertaining to observations during record review. The purpose of the report was explained to staff.

During complaint investigation, LPA Gutierrez discovered that Administrator failed to report R1’s hospitalization to Community Care Licensing, facility does not have a dementia care plan in the facility Plan of Operation and S3 did not have a criminal background.

Based on observation, a citation is being issued. See LIC 809D.

An exit interview was conducted, and a copy of the report and appeal rights were issued.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction