Facility Evaluation Report
Capacity6
Census4
Date signed12/15/2025 01:04:56 PM
Name of licensing program analystYi Sam Jian
Name of licensing program managerBrenda Chan
On 12/15/2025, Licensed Program Analyst (LPA) Yi Sam Jian arrived at the facility to deliver amended copy of LIC9099 for complaint number 14-AS-20250618092722. LPA met with staff Alicia Monton(S1), LPA explained the purpose of the visit. Administrator Nancy Uy(S3) was contacted over phone and gave permission for Staff S1 to sign required paperwork.
This report was reviewed with staff S1 and copy was provided to facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction