Senior Care Records.

Facility Evaluation Report

Sam's Homecare, Yorba Linda08/11/2025Licence 306004176

Capacity6
Census4
Date signed08/11/2025 11:14:36 AM
Name of licensing program analystEdward Kim
Name of licensing program managerLourdes Montoya
The inspector’s account

On August 11, 2025, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced case management POC visit in conjunction with the annual continuation visit on August 11, 2025. LPA met with Administrator Juhayna Diaz and explained the purpose for the visit.

LPA observed R1, R2, and R4 had all their Appraisals Needs and Service Plan updated dated August 5, 2025. LPA observed that auditory devices in the front entrance, vacant resident room, and backyard exit were all in working order. The deficiencies (See LIC 809D dated 8/4/2024) have been cleared. A facility representative was provided with the POC letter documenting the corrections.

An exit interview was conducted, and a copy of this report, LIC811, and POC letter were provided to Administrator Juhayna Diaz.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction