Facility Evaluation Report

On 12/7/2022 at 12:05PM, Licensing Program Analysts (LPAs) G. Luk and K. Nguyen arrived unannounced to conduct a POC (proof of correction) inspection. LPAs met with caregiver, Ofelia Calderon informed her the reason for the visit. LPAs spoke with licensee, Merdith Castro over the phone and stated that POC will be sent to LPAs later today.

Facility has the following deficiencies that were not cleared and deficiencies were issued on 11/18/2022 from California Code of Regulations, Title 22 :

- 87405(d); LPAs have not received new administrator information from licensee.

- 87205(a); LPAs have not received a written statement/plan.

- 87213; LPAs have not received a written statement/plan.

- 87755(b); LPAs have not received a written statement/plan.

POC due date was extended until 11/30/2022 for all four deficiencies.

Civil penalties of $700 is assessed for the period of 12/1/2022 to 12/7/2022 for failure to correct for each deficiencies 87405(d), 87205(a), 87213, and 87755(b). Total civil penalties in the amount of $2800 is being assessed today. Facility is subject to ongoing civil penalties until deficiencies are corrected.

Exit interview conducted. A copy of this report, civil penalties, and appeal rights provided.