Facility Evaluation Report
Capacity6
Census5
Date signed12/03/2025 12:00:18 PM
Name of licensing program analystGina Saucedo
Name of licensing program managerTroy Agard
On 12/03/25, at 9:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Administrator, Nestor Tumaliuan. This Case Management is conjunction with complaint number-31-AS-20251201104955. LPA did not get an Unusual/Incident Injury report regarding resident #1 (R1) going to the hospital and their extensive stay there.
An exit interview was conducted, citation(s) were issued, appeal rights were provided, and a copy of this report was given to the administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction