Facility Evaluation Report

On 07/29/2026, Licensing Program Analyst (LPA) Melina Oropeza arrived at this facility unannounced to conduct a case management visit. LPA was met by Administrator, Avinesh Ram. LPA explained the purpose of the visit to administrator. Administrator certificate # 7021233735 expires 12/29/2027.

The facility has a current census of 2. A brief interview was conducted with the Administrator.

The purpose of this case management visit was to conduct a quarterly visit as outlined from the Non Compliance Conference held on 02/27/2025 and the requirement to have increased monitoring at that time.

The focus of this quarterly visit was to review the following items that were initially brought forth on 02/27/2025:

Complete and submit the LIC 500 for the most current staff, shifts, and coverage for designated shift leads. LPA reviewed LIC 500 dated 07/01/26.

Complete and submit the LIC 308. LPA reviewed LIC 308 dated 03/04/26.

Complete and submit the LIC 309. LPA reviewed LIC 309 dated 03/04/26.

Complete and submit proof of most recent training in the areas of Resident Personal Rights, Resident Care and Resident Supervision and Reporting Requirements. Proof of submission to include name of trainer, topics covered with duration of training, and list of all attendees. LPA verified the completion of training for: Licensee, Renee Tang has completed 11 hours of the above listed trainings. Administrator, Avinesh has completed 3 hours of Introduction to HCBS. Staff (S1) has completed 3 hours of Modification of Rights and HCBS.