Facility Evaluation Report

While conducting investigation of a complaint (Control Number 15-AS-20251028151917), Licensing Program Analyst (LPA) Delmundo learned the following:

1. Former staff (FS) using the dining area as sleeping quarter.

2. Administrator did not submit report when she received a video footage showing an incident between staff (S1 and S2) and client (C1).

Deficiencies are cited from Title 22 California Code of Regulations and listed on 809D. Failure to submit proof of corrections (POCs) by plan of correction due dates and any repeat violation within 12 month period may result in civil penalty.

Deficiencies and plan and proof of corrections were discussed with licensee over the phone in the presence of ADM.

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