Facility Evaluation Report
Capacity15
Census8
Date signed08/22/2025 01:23:57 PM
Name of licensing program analystRobert Frank
Name of licensing program managerVictoria Bertozzi
Licensing Program Analyst (LPA) Robert Frank arrived unannounced for a Case Management visit.
The facility is being cited for not having a currently certified Administrator.
Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections and Appeal Rights discussed and provided to Caregiver Yolanda Buenaflor . Signature on form confirms receipt of documents.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction