Facility Evaluation Report

Gus Residential Home INC., Beaumont03/07/2023Licence 335530081

Capacity4
Census0
Date signed03/20/2023 10:00:29 AM
The inspector’s account

Licensing Program Analyst (LPA) Victoria Chitgian conducted an announced visit to the facility to conduct a pre-licensing inspection. LPA met with Augusta Momodu.

Based on observations made by the LPA, the pre-licensing inspection is not able to be completed at this time due to inconsistencies on the floor plan. Submitted floor plan layout has indicated one(1) bathroom. Walk-through of the facility shows to have two(2) bathrooms on the first floor layout.

COMP III was completed during the visit. LPA and licensee will reschedule a follow up inspection once correction has been completed.

Pre-Licensing is incomplete. A follow up Pre-Licensure LIC 809 will be generated upon completion.

An exit interview was conducted where is report was discussed and provided to Augusta Momodu.

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