Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to cite a deficiencies identified during a separate complaint investigation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Victoria “Vicky” Azucena.

On 08/04/2025, Licensee served Client #1 (C1) with a 30-day eviction notice letter, which essentially stated that C1 did not comply with general facility policies and that the facility could no longer meet C1’s needs. [See LIC811 Confidential Names List for a description of C1.] However, the eviction letter did not contain “specific facts including the date, place, witnesses, and circumstances” that justified the reason(s) for eviction, as required. Licensee also did not submit a copy of C1’s 08/04/2025 eviction letter to CCLD within five (5) days of service to C1, as required.

Two (2) deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). Plans of Correction was jointly developed with the Licensee.

An exit interview was conducted with Caregiver Victoria “Vicky” Azucena, to whom a copy of this report, the LIC 809-D, and the Licensee/Appeal Rights (LIC9058 03/22) were provided. A set of these same documents was E-mailed to Licensee and facility management.