Facility Evaluation Report
Capacity6
Census4
Date signed03/26/2026 11:12:22 AM
Name of licensing program analystAbdoulaye Zerbo
Name of licensing program managerAnthony Perez
This Case management– Deficiencies inspection is being conducted by Licensing Program Analyst (LPA) Abdoulaye Zerbo for the purpose of issuing citations for deficiencies observed during the visit on 03-26-26. LPA met with Caregiver Ruben Yamuta and explained purpose of the visit.
During the visit, LPA reviewed R1 records and noticed R1's file was incomplete.
Based on record review and interviews, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809-D.
An exit interview was conducted, and a copy of this report and appeal rights was discussed with and provided to Caregiver Ruben Yamuta.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction