Complaint Investigation Report
Census2
Date signed09/15/2025 12:13:37 PM
Deficiencies are cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, or repeat violations within a 12-month period, may result in a civil penalty assessment. Appeal rights were provided. See LIC9099D.
Exit interview conducted with House Manager, whose signature on form confirms receipt.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction