Facility Evaluation Report

On this day, April 1, 2026, while at the facility investigating a complaint (Control # 15-AS-20260326120524) and upon conducting interviews and record review, Licensing Program Analyst (LPA) Delmundo learned that the resident's 1:1 is not fingerprinted. LPA also learned that the facility did not submit incident report and SOC341 for the alleged financial abuse that occurred on January 2026.

Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. A $500.00 civil penalty is assessed for deficiency section # 87355(e)(2) and will continue until corrected. Failure to submit proof of correction by plan of correction due date for the other deficiency may result in additional civil penalty.

Deficiencies, civil penalty, and plan and proof of corrections were discussed with ED.

Exit interview conducted. Appeal Rights, LIC421IM Civil Penalty Assessment, LIC9098 Proof of Correction form and copy of this report provided.