Facility Evaluation Report

On this day, 12/18/24, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a case management health and safety check as a result of a complaint (15-AS-20241213155842) received by the Department. LPA met with Daphna Garcia, administrator, and informed the reason for visit. LPA spoke on the phone with Kim Fields, licensee.

LPA toured the facility inside out with the administrator.

-at 10:30 am, disinfectant spray in the resident's room.

-at 10:40 am, unlocked garage where construction equipment, pail of paint, Raid ant and roach killer are stored.

-at 10:50 am, unlocked storage in the backyard where rake is kept.

-at 11:00 am, chemical spray tank in the backyard.

Deficiency is cited from Title 22 California Code of Regulations, and listed on 809D. Failure to submit proof of correction by plan of correction due date and any repeat violation may result in civil penalty.

Deficiency and plan and proof of correction were discussed with the administrator and on the phone with licensee.

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