Facility Evaluation Report
Capacity6
Census6
Date signed04/22/2022 03:46:08 PM
Licensing Program Analyst (LPA) Marybeth Donovan arrived unannounced to conduct a Case Management Visit regarding the Death Report for resident (C1). LPA met with Evelyn Canonizado Administrator and Nida Reguindin Caregiver.
LPA toured the facility inside and out. LPA interviewed the Administrator, 2 staff and reviewed C1 client records.
C1 passed away on 4/19/2022. The cause of death is to be confirmed. Additional information is need to complete the Case Management.
LPA reviewed this report with Evelyn Canonizado Administrator and a copy provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction