Facility Evaluation Report
Capacity6
Census0
Date signed06/16/2025 02:12:32 PM
Name of licensing program analystKevin Gould
Name of licensing program managerCzarrina A Camilon-Lee
On 6/16/25 at 12:00pm, Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management visit to serve the facility an Immediate Exclusion Order for staff member R1 (see confidential names list, LIC 811 dated 6/16/25).
LPA met with facility Administrator, Kassia Mitchell and provided the Immediate Exclusion Order for R1. Statements from the facility administrator indicate the individual is no longer working at this facility and LPA requested the facility remove R1 from being associated to this facility.
Exit interview conducted and a copy of this report was left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction