Facility Evaluation Report

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required 1-Year Visit. LPA was greeted by, Jillian Chan daughter of Caregiver, Jessie Chan to whom she identified herself. LPA spoke with the Caregiver, Jessie Chan over the telephone and explained the reason for the visit. During the visit Chan arrived at the facility.

Currently there are no residents in care. The residents in care (2) moved out on June 7, 2025 to another licensed facility, Ideal Home Care (374604611). LPA confirmed with Licensee, Josefina Hulsey that both residents were living at the facility.

During today's visit, Caregiver Chan informed LPA that the Licensee, Jeffrey Chan would like to change the facility type to Adult Residential Facility. LPA explained that the application to change facility type would need to be processed by CAB.

LPA explained that no clients that do not meet the current licensed criteria may be admitted to this facility until the facility is officially licensed as an Adult Residential Facility.

LPA did not observed any violations during today's visit.

An exit interview was conducted with Caregiver, Jessie Chan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.