Facility Evaluation Report
Capacity6
Census6
Date signed09/19/2025 03:21:51 PM
Name of licensing program analystAlbert Johnson
Name of licensing program managerLisa Rios
LPA Johnson arrived at the care facility to conduct a case management visit regarding annual fees.
LPA toured the facility and spoke with residents. No concerns at this time.
According to Licensing Information System, the facility due on 11/17/2025 for annual licensing fees in the amount of $495.00. For your convenience, your PIN is 179679.
Licensing Information System documents / billing were left at the facility regarding the due fees,
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction