Facility Evaluation Report

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Health Services Administrator (HSA) Venus Jo, Director of Wellness (DOW) Deeanna Lyons, and Social Worker Eileen Carandang.

Community Care Licensing received a self report on 01/16/26 in which the facility shared concerns regarding a resident (identified as R1) and their responsible party, pertaining to R1's care.

During today's visit, LPA conducted interviews and file review, as well as a visit with R1. LPA provided consultation with HSA Jo, DOW Lyons, and Social Worker Carnadang. Thus far the facility has responded appropriately to the shared concerns.

At this time, LPA observed no health and/or safety concerns and no deficiencies were cited during today's visit. An exit interview was conducted with Health Services Administrator Jo to whom a copy of this report was provided. Their signature below confirms receipt of this document.