Facility Evaluation Report
Capacity6
Census5
Date signed05/15/2024 02:36:09 PM
Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 5/15/24 to conduct a Required-1 Year Inspection utilizing the inspection tool.
LPA interviewed two (2) residents during inspection. LPA reviewed three (3) resident files and one (1) staff file. Facility has a current copy of certificate of liability insurance and LPA obtained a copy.
As a result of today's visit, no deficiencies were cited per California Code of Regulations, Title 22. LPA will return at a later time to complete annual inspection.
Exit interview conducted and copy of report given at the conclusion of this visit.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction