Facility Evaluation Report
Capacity6
Census3
Date signed05/22/2025 02:07:36 PM
Name of licensing program analystRenese Howell-Small
Name of licensing program managerKaren Clemons
On 05/22/2025 Licensing Program Analysts (LPAs) Renese Howell-Small and Becky Mann arrived to the facility unannounced to conduct a Case Management visit in order to obtain a signature on the LIC9099 report referencing complaint: 56-AS-20241126101245 .
LPAs were greeted by staff, granted entry, stated the purpose of the visit to staff
An exit interview was conducted where this report LIC809 and the signed LIC9099 report was discussed and a copy provided to staff.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction