Senior Care Records.

Facility Evaluation Report

Good Shepherd of Dublin, the, Dublin03/24/2023Licence 019200847

Capacity6
Census6
Date signed03/24/2023 08:47:58 AM
The inspector’s account

On 3/24/2023 at 8:00AM, Licensing Program Analysts (LPAs) K. Nguyen and G. Luk arrived unannounced to conduct a POC (proof of correction) inspection. LPAs met with caregiver, Lester Calma. LPAs was unable to speak with the licensee. Administrator Isagani Silvestre later arrived at 8:25am.

Facility has the following deficiency that was not cleared :

- HSC1569.652(c); LPA. K. Nguyen did not receive POC due on 2/24/23 and licensee have not provided the documents.

Civil Penalties in the amount of $1,600 is assess today for the period of 3/09/23 to 3/24/23 for failure to meet POC date for deficiency HSC1569.652(c). Facility is subject to ongoing civil penalties until deficiency is corrected.

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

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction