Facility Evaluation Report
Capacity4
Census4
Date signed06/26/2025 10:36:11 AM
Name of licensing program analystAlbert Johnson
Name of licensing program managerLisa Rios
LPA Albert Johnson made an unannounced visit on this date to complete a health and safety check and to follow-up on annual fees.
The facility will be current with fees in July of this year.
LIC308 - Designation of Administrative Responsibility ,
LIC 309 – Administration Organization (for any LLC or Corp),
An updated Liability Insurance Certificate ,
As well as an updated Lease Agreement , if applicable.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction