Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio and Licensing Program Manager (LPM) Stephen Richardson arrived unannounced to the facility to conduct a case management visit. LPA Valerio was informed that residents were moving out from the facility and the last resident would be gone by COB 08/18/2023.

LPA Valerio and LPM Richardson was met by facility staff Verly Mendoza. Staff stated there is only 1 resident in care. The other two residents moved out on 08/15/23 and 08/17/23. The last resident is to move out at 2:00 PM on 08/18/23. LPA and LPM contacted Licensee Antonette Tin via cell phone and requested her to come to the facility. Licensee Antonette Tin arrived to the facility at 02:00 PM. According to Licensee, the two residents were not told to move out and they left for personal reasons. Personal reasons were not disclosed to CCL or Licensee. At the end of the visit, 0 residents were observed to be in care.

Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8 - no deficiencies are being cited. An exit interview was held with Licensee, and copy of the report was provided.