Facility Evaluation Report
Capacity4
Census3
Date signed01/14/2026 02:53:01 PM
Name of licensing program analystMariana Agban
Name of licensing program managerNichelle Gillyard
In conjunction to the complaint 31-AS-20260113094025 LPA Mariana Agban conducted Case Management - Deficiencies. During the course of investigation, it was discovered that Staff#1(S1) doesn't have a physical employee file in the facility. LPA was informed that S1 was hired mid December of 2025. It was also discovered that Client#1(C1) had no updated medical assessment and Client#2(C2) had no medical assessment done. Administrator stated that he will provide the required documents promptly.
Exit interview conducted, Citations issued, Appeal rights given and a copy of this report delivered.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction