Senior Care Records.

Facility Evaluation Report

G.l.o.m. A.r.f. 3, Stockton11/03/2023Licence 392700629

Capacity15
Census11
Date signed11/03/2023 12:00:35 PM
The inspector’s account

On November 03, 2023 At 9:00 AM, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to deliver an Order of Exclusion for a staff member. LPA Lewis with Monce Huerta and explained the purpose of today's visit.

LPA Lewis was informed by Monc Huerta , the staff member named in the Order of Exclusion, Edmond, Rahas L., no longer works at the facility.

LPA Lewis provided Monce Huerta with a copy of the Order and explained that Edmond, Rahas L. is not allowed in the facility effective immediately.

A tour of the kitchen area was conducted. A review of food supply was done to ensure a 2 day perishable and 7 day non-perishable food supply was available.

Exit interview was held, and a copy of this report and Immediate Exclusion letter were provided to the facility.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction