Facility Evaluation Report
Capacity72
Census48
Date signed11/04/2025 02:24:34 PM
Name of licensing program analystJacques Leffall
Name of licensing program managerSee Moua
On 11/4/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced for a case management visit regarding a Default Decision and Order for Staff 1 (S1). LPA met with Resident Care Director (RCD) Brittaney Polman. RCD verified Anthony Davis is not employed. LPA conducted visit to verify an individual that no longer has a criminal record clearance is working at the facility.
LPA was informed by Administrator that Staff member is not employed at the facility and no longer associated with the facility.
Exit interview was conducted. A copy of this report was provided to RCD, whose signature confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction