Facility Evaluation Report

At approximately 8:30 AM, Licensing Program Analyst (LPA) Robert Frank arrived at the home for the purpose of conducting a closure inspection pursuant to voluntary closure of this licensed Residential Care Facility for the Elderly. LPA met with Administrator Denice Tambauan who submitted the written notice letter of facility closure to the Santa Rosa Regional Office via e-mail on 05/16/2025. The letter indicates the facility is closing due to difficulties and prolonged non-admission of residents.

LPA inspected all rooms and the exterior of the building today and found no evidence that would suggest that any residents are residing on the premises.

The Administrator initiated this facility closure and did not submit a closure plan as there have never been any residents admitted to the facility since the license was granted.

Closure of this facility has been finalized. Facility was closed effective 05/30/2025. Licensee turned over copy of License during today's inspection.

No deficiencies cited during today's visit.

Exit interview conducted. Copy of report discussed and provided to Administrator Tambauan. Signature on form confirms receipt of documents.