Facility Evaluation Report
Capacity6
Census3
Date signed12/05/2024 02:52:06 PM
Licensing Program Analyst (LPA) Gary Tan conducted an unannounced case management visit at this facility to cite the deficiency discovered while investigating complaint control no.: 31-AS-20241127152622. During LPA's record review, LPA discovered that Staff #1 (S1) is not associated at this facility during this visit.
Citation issued. Civil penalty assessed. Appeal rights discussed and given.
Exit interview conducted. Copy of this report issued.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction