Facility Evaluation Report
Capacity6
Census4
Date signed08/14/2023 02:58:28 PM
Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced Proof of Correction (POC) visit for deficiency cited on form LIC9099-D issued on 07/28/2023.
During this visit, LPA inspected the physical plant and observed that Staff 1 (S1) is separated from this facility. LPA conducted staff and resident interviewed that acknowledged S1 was disassociated to the facility.
Letter of Cleared POC was issued during today's visit. This report was reviewed with, and a copy was provided to Agnes Edi
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction