Facility Evaluation Report
Capacity4
Date signed10/27/2025 03:40:43 PM
Name of licensing program analystAmy Domingo
Name of licensing program managerSimon Jacob
Licensing Program Analyst LPA Amy Domingo attempted to conduct a 1 year annual inspection. LPA Domingo rang the door bell with no answer. LPA Domingo called Dominique Masa the Administrator and he stated that the facility and all the residents were moved to another location. LPA stated no paper work was sent to the Regional Office. He apologized and stated that his primary concern was safely moving the residents. He stated that he has 30 days to request or file for the facility to be closed. LPA stated that the information will be sent to him on closure of a facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction