Facility Evaluation Report

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to the facility to conduct a case management visit on the health, safety, and welfare of residents in care. LPA met with Jeffrey

Gomez. LPA was informed that three (3) residents currently reside at this facility. There were four (4) staff on duty during the time of the visit and visiting Psychiatrist that comes monthly to the facility.

LPA toured the facility and observed all facility utilities to be on and operating without issue, food supply is sufficient, there is no immediate concern for residents in care .

No deficiencies are being cited and no civil penalties per California Health & Safety Code and Code of Regulations, Title 22, Division 6. An exit interview was conducted with Jeffrey

Gomez and a copy of this report will be emailed and a receipt of confirmation will be requested.