Facility Evaluation Report
Capacity6
Census6
Date signed05/06/2025 12:29:12 PM
Name of licensing program analystCassandra Mikkelson
Name of licensing program managerLaura Munoz
Licensing Program Analyst (LPA) Cassandra Mikkelson conducted an unannounced visit to the facility and met with Administrator Teresa Carter. The purpose of this visit was to conduct a collateral visit to observe Resident R1 and interview Administrator.
LPA observed Resident R1 during the visit and conducted a tour of R1's room. LPA conducted a file review for R1 and requested copies of documents pertinent to the invesitgation. LPA also interviewed Administrator.
No deficiencies cited during this visit. A copy of this report was left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction