Facility Evaluation Report
Capacity11
Census10
Date signed06/28/2022 11:09:49 AM
At approximately 10:20AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Collateral Visit and met with Administrator, Jim Sirokman. The purpose of the visit was to review and obtain facility records concerning a former resident.
LPA Felias conducted a walk through of facility.
Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction