Facility Evaluation Report
On July 15, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection utilizing the inspection tool. LPA met with co-Administrator and explained the purpose of the visit.
Today's census is six residents in care with zero residents on hospice. Facility is licensed for six non-ambulatory with hospice waiver for four.
During today's visit, LPA and co-Administrator conducted a file review for six residents in care. LPA observed R1 to be recently admitted to the facility but did not observe a medical assessment on file. LPA was informed admission agreement and medical assessments may be with Administrator. LPA observed R2's LIC 602 is on file which indicated R2 is bedridden. LPA did not observe R3's LIC 602 on file as facility had provided the original copy to emergency medical services, but co-Administrator has an electronic copy. Electronic copy indicated R3 is bedridden.
LPA was unable to complete today's inspection due to lack of time. LPA will return at a later day to complete inspection and inspection tool.
Exit interview conducted, a copy of report and appeal rights provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction