Facility Evaluation Report
Capacity6
Census3
Date signed03/22/2023 11:37:01 AM
Licensing Program Analyst (LPA) Lavinia Muscan and Auditor Jacqueline Juarez arrived at the facility unannounced on 3/22/23 to conduct a case management visit to request documents for a facility audit. LPA and Auditor met with Administrator, Derbbie Ninobla and explained the purpose of the visit.
Copy of admission agreement, physicians report and rent checks were reviewed and obtained. Needs and service plan to be emailed to CCLD.
As a result of today’s visit, no deficiencies were noted or cited.
Exit interview conducted and copy of report left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction