Senior Care Records.

Facility Evaluation Report

Chantilly Lace Manor II, Hesperia10/15/2025Licence 366426709

Capacity6
Census6
Date signed10/15/2025 12:38:10 PM
Name of licensing program analystMagda Malcore
Name of licensing program managerKaren Clemons
The inspector’s account

Licensing Program Analysts (LPAs) Magda Malcore and Eldin Serrano conducted an unannounced visit to the facility. LPAs met with staff, Heilala Poloa, explained the purpose of the visit and was granted entry into the facility.

During today's visit, LPAs requested from staff Poloa, resident registry, resident files which contain resident admission's agreement and physician's reports pertaining to complaint investigation 56-AS-20251008092142 . Staff stated that that they did not have access to resident files that contain that information.

A deficiency is being cited in accordance with Title 22 of the California Code of regulations.

An exit interview was conducted where this report was discussed and a copy provided with appeal rights to Staff Poloa at the conclusion of the visit.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction