Facility Evaluation Report
Capacity6
Census4
Date signed01/19/2024 04:48:07 PM
On this day, January 19, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the annual required inspection that was started on January 11, 2024. LPA was granted entry by staff, Rosemarie Wright, and informed the reason for visit. LPA also met with other staff, Nenita Guzman. Maria Gracia Golitzen, arrived after several minutes.
LPA reviewed 4 residents records and checked the P&I. Medications were inspected, compared with doctor's order of medications and LIC622 Centrally Stored Medication and Destruction Records.
Exit interview conducted. Copy of this report provided to the administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction