Facility Evaluation Report
Capacity24
Census19
Date signed10/30/2025 02:29:51 PM
Name of licensing program analystElias Magdaleno
Name of licensing program managerVictoria Bertozzi
Licensing Program Analyst (LPA) Magdaleno arrived at approximately 1:45 PM to conduct a Case Management-Other visit and was greeted by Administrator Vincent Waller.
The purpose of this visit was to follow-up on a Death Report received by Community Care Licensing (CCL) regarding a resident who passed outside of the facility. Administrator stated they would submit Death Certificate and Coroner's Report as soon as they are made available.
LPA requested documents and conducted interviews.
No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction