Facility Evaluation Report
Capacity4
Census4
Date signed05/22/2025 12:30:05 PM
Name of licensing program analystKerry Hiratsuka
Name of licensing program managerTroy Ordonez
LPA Hiratsuka conducted this unannounced annual visit. LPA toured the facility with Colleena Johnson.
This facility has a fire clearance for three ambulatory and one non-ambulatory residents This facility has four residents. There are four resident rooms and one staff room. There is one full common bathroom and one bathroom in the staff room. There are locked cabinets for cleaning products and medications.
No health and safety issues were observed.
Staff and resident records were reviewed.
No deficiencies are being cited as a result of todays inspection
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction