Facility Evaluation Report

On 2/3/2023 at 11:55AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a POC (proof of correction) inspection. LPA met with caregiver, Lester Calma informed him the reason for the visit.

The following deficiency was cleared by visit :

- 87405(d); LPA received email from licensee on stating new administrator was hired.

- 87205(a); LPA received a written statement/plan on 1/5/2023.

- 87213; LPA received a written statement/plan on 1/5/2023.

- 87755(b); LPA received a written statement/plan on 1/5/2023.

Civil penalties of $800 is assessed for the period of 12/29/2022 to 1/5/2023 for failure to correct for each deficiencies 87405(d), 87205(a), 87213, and 87755(b). Total civil penalties in the amount of $3200 is being assessed today.

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