Facility Evaluation Report
Capacity6
Census4
Date signed05/22/2026 01:46:21 PM
Name of licensing program analystKamaldeep Kaur
Name of licensing program managerAlexandria Walton
On 5/22/2026, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct an initial 10-day complaint inspection. During the course of the investigation, it was discovered facility files were unavailable due to administrator being out of town.
All client records shall be available to the licensing agency to inspect, audit, and copy upon demand. Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6.
Exit Interview conducted. Report signed on site by staff; whose signature on this form confirms receipt of this document.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction