Facility Evaluation Report
Capacity47
Census43
Date signed08/29/2025 12:25:01 PM
Name of licensing program analystAmy Rodgers
Name of licensing program managerSimon Jacob
Licensing Program Analyst (LPA) Amy Rodgers onducted an unannounced case management visit to follow up on an incident reported to Community Care Licensing. LPA met with Karl Diaz, Co-t Administrator, and discussed the purpose of the visit.
Community Care Licensing received an incident report on August 29, 2025. During today's visit, LPA collected pertinent resident records as well as conducted a health and safety check of the residents in care.
No deficiencies were cited during today’s visit.
Karl Diaz, Co Administrator, was provided a copy of this report, appeal rights (LIC9058 03/22), and a LIC 811.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction