Facility Evaluation Report
Capacity4
Census3
Date signed06/29/2026 05:11:41 PM
Name of licensing program analystJacques Leffall
Name of licensing program managerSee Moua
On 6/29/26, Licensing Program Analyst (LPA) J. Leffall conducted a case management visit to follow up and confirm details of an incident report that was received by the Department. The incident occurred on 6/16/226, in which R1 was given evening medication with the morning medication. LPA met with Administrator Artaja Stovall.
S1 has received medication training and has been mandated not to administer future medications.
A citation and is being issued on the attached 809-D regarding the medication error.
A copy of this report with Appeal Rights were issued to Administrator whose signature confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction