Facility Evaluation Report

LIcensing Program Analyst (LPA) Ramon Serrano conducted a Case Management visit regarding an increase in capacity application. LPA identified himself and discussed the purpose of the visit with Administrator Mark Carrillo.

Licensee applied for an increase in capacity from a total capacity of three (3) clients to a total capacity of five (5) clients all of whom must be ambulatory. There is an approved Fire Clearance dated 4/24/26 for the increase in capacity. LPA inspected all rooms on the facility sketch (LIC999), that accompanied the STD850, Fire Safety Inspection Request, and no issues were observed or noted.

This portion of the application process is complete, and will be forwarded to management for final review and approval. The Licensee will then be notified and the new license will be mailed to the Licensee.

No deficiencies were issued during this visit.

An exit interview was conducted with Mark Carrillo to whom a copy of this report, along with Licensee/Appeal Rights (LIC 9058), were provided at the conclusion of the visit.