Facility Evaluation Report
Capacity6
Census4
Date signed04/17/2025 02:41:20 PM
Name of licensing program analystDavid Roman
Name of licensing program managerLizzette Tellez
Licensing Program Analyst (LPA) David Roman conducted an unannounced case management visit to deliver an amended report for a visit conducted on 1/15/2025. LPA D. Roman identified himself, was greeted by and discussed the purpose of the visit with Supervisor, Maniza Ambalada.
During the visit, LPA obtained Maniza Ambalada’s signature on the amended report.
An exit interview was conducted with Supervisor Maniza Ambalada. A copy of this report and the Licensee’s Rights were provided via hard copy.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction