Facility Evaluation Report

On June 29, 2026, at 9:45 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced Case Management Visit to follow-up on deficiencies cited in forms LIC809D on June 15, 2026. LPA Kim was greeted and granted entry by Caregiver (CG) Dania Gonzalez Callero. LPA Kim called Licensee (LICEN) Allen Medina over the phone and LPA explained the purpose of the visit. LICEN Medina informed LPA Kim that Staff Rosendo Carlo Ward could sign on behalf of the facility for the report.

LPA Kim toured the physical plant and made the following observations.

Deficiency cited under Title 22 Regulation California Health and Safety Code (HSC) 1569.38(e) pertaining to posting a notice in a conspicuous location about the Department commencing proceedings to revoke the facility license has been cleared. The facility posted the notice by the entryway, which was observed during the visit.

Deficiency cited under Title 22 Regulation California Health and Safety Code (HSC) 1569.38(b)(1) pertaining to a licensed facility shall provide written notice to a resident, the resident’s responsible party within 10 days from the occurrence of the Department commencing proceedings to suspend license of the facility. LPA observed facility provide a notice the resident and mail out a notice to other residents.

Licensee has been advised to maintain all items especially those that were previously deficient in the facility in accordance with Title 22 Regulations.

An exit interview was conducted and a copy of this report and POC Clearance letter were provided to Staff Rosendo Carlo Ward