Facility Evaluation Report
Capacity6
Census4
Date signed05/23/2025 04:53:43 PM
Name of licensing program analystEdward Kim
Name of licensing program managerLourdes Montoya
On this day, Licensing Program Analyst (LPA) Edward Kim conducted a case management visit to document a deficiency observed during the investigation of complaint 22-AS-20250519120454 but unrelated to the allegations investigated.
During a tour of the physical plant, LPA observed the facility did not notify the Regional Office about the change of administrator.
A deficiency was cited per Title 22 Division 8 Chapter 6. The facility did not notify Regional office about the change of administrator.
An exit interview was conducted and a copy of this report and appeal rights were provided to Licensee Thi Nhu Mai Do.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction