Facility Evaluation Report
Capacity6
Census3
Date signed03/10/2026 03:30:54 PM
Name of licensing program analystYi Sam Jian
Name of licensing program managerBrenda Chan
On 03/10/2026, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced case management inspection. LPA met with staff member, Wayne Smith. LPA explained the purpose of the visit.
LPA conducted a Health & Safety Check and toured the facility inside including all of resident rooms, common areas, kitchen area.
Deficiency was cited per California Code of Regulations, Title 22. See LIC809-D. Failure to correct the deficiencies may result in civil penalties.
This report is reviewed and discussed with the staff; a copy and appeal right are provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction