Facility Evaluation Report

At 10:00 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted a Case Management visit - CLOSURE and met with the Administrator. An entrance Interview was conducted.

During the visit LPA was given a tour of the facility. LPA confirmed that there were no residents residing in the facility and that operation had ceased. The reason for closure of the facility is Licensee initiated due to the retirement of the Licensee and the Administrator. Administrator surrendered the License to LPA.

LPA will submit the file for closure upon returning to the Woodland Hills South Regional Office. The Administrator was reminded that she is not to admit/retain any residents at the home who require care and supervision.

Exit Interview conducted and copy of this report signed and delivered.