Facility Evaluation Report
Capacity6
Census4
Date signed06/15/2026 11:51:48 AM
Name of licensing program analystMariana Agban
Name of licensing program managerMary G Flores
Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced continuation of the annual inspection. LPA met with staff and disclosed the reason for the visit. LPA conducted a file review of resident records to ensure compliance of licensing forms. LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Medication and Medication Records were review for proper documentation.
Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction