Facility Evaluation Report
Capacity110
Date signed09/11/2025 02:10:30 PM
Name of licensing program analystDina Alviso
Name of licensing program managerBethany Moellers
Licensing Prigram Analyst (LPA) Alviso conducted a case management inspection, on 9/11/25 at approximately 10:20am, and met with Administrator Karina Tapia, and Cheyenne Flores, LVN/Health Services Director.
The case management is being conducted to review a resident incident, and death report, the facility Administrator reported to the Department. LPA reviewed records on former resident (R1).and obtained requested copies of documentation/records. LPA reviewed care plan, assessments, progress notes, admission documents, medication list, and medical documentation, including Dr's Orders.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction