Facility Evaluation Report
On 07/28/2025 at 11:15 am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today's visit was to conduct the one-year inspection. LPA met with Elsa Roman, Administrator and the purpose of the visit was discussed. The The facility is licensed to serve 6 non-ambulatory only residents and a waiver granted for an approved hospice care for five (5) residents. Five (5) of the residents are diagnosed with dementia, zero (0) residents receive home health, and one (1) of the residents are receiving hospice care services. The facility does not handle any of the residents’ money.
The facility has a current administrator certificate (#7012218740) for Elsa Roman valid from 06/24/2024 - 06/23/2026. The facility fees are current. The facility has liability insurance with James River Casualty Company (NAIC# 13685) with each occurrence at $1,000,000 and general aggregate at $3,000,000 (policy #00150009-1) effective date 11/17/2024 - 11/17/2025. The facility fees are current.
The home is a single home consisting of : (5) resident bedrooms, (2) full bathrooms, living room, a kitchen, a washer and dryer area, a dining area, a living room, a backyard with two (2) shed with additional storage and an outdoor shaded patio are in the backyard.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction