Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Tan conducted an unannounced case management visit at this facility to conduct a health and safety check to ensure that everything is in order and to confirm the termination of the operational agreement based on the information CCLD received on 11/19/25 which would result to cessation of operation of this facility. LPA met with staff Erika Stinson who called the Administrator Rod Stinson and explained the reason for the visit. Mr. Stinson designated Ms. Erika Stinson to sign the report.

LPA conducted physical plant tour at 9:23 AM and observed that the facility is generally clean and have sufficient amount of food in stock for the current census of the facility. LPA also interviewed three (3) residents today between 10:00 AM to 11:30 AM, three (3) out of three (3) residents stated that everything is okay and they are aware that they are leaving and there is no untoward incident happened recently.

There is no health and safety hazard observed during this visit.

Exit interview conducted. Copy of this report issued.