Facility Evaluation Report

At approximately 1:35 PM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced for a Case Management - Other visit and met with Executive Director Jeremy Cleek and Assisted Living Director Veronica de Leon-Tan

The purpose of this visit was to follow up on a Death Report (DR) regarding resident (R1) received by Community Care Licensing (CCL) on 6/19/2026 and two (2) Incident Reports (IRs) regarding resident (R2) received on 6/23/2026. LPA gathered First Aid/CPR certifications for staff present during the passing of R1, conducted interviews, and requested further documentation. IRs indicated that R2 spilled hot liquids on themselves resulting in blisters that were later diagnosed as second-degree burns. LPA gathered documents and conducted interviews.

No deficiencies cited. Exit interview conducted with Executive Director whose signature on form confirms receipt.