Facility Evaluation Report
Capacity6
Census3
Date signed10/03/2025 03:27:08 PM
Name of licensing program analystRegina Cloyd
Name of licensing program managerUlysses Coronel
On 10/03/2025, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced Required – Annual Inspection and met with House Manager Angelito Costa .
During today's visit, LPA conducted a tour of the physical plant, reviewed five staff records, three resident records, two medications, and facility documents.
Due to insufficient time, an annual continuation visit is required.
An exit interview was conducted with and a copy of this report was provided to the House Manager Angelito Costa.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction