Facility Evaluation Report
Capacity5
Census4
Date signed08/02/2022 01:49:23 PM
On 8-2-22 at 1:41pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit. LPA met with assistant administrator Carrie Mumphrey and explained the purpose of the visit. Licensee William Puckett was made aware of LPA's visit. The purpose of this case management was to amend document 9099A originally issued on 7-28-22 related to complaint #27-AS-20220712153932. Form was amended and signed by Carrie Mumphrey.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction