Facility Evaluation Report

On 7/19/2024 at 10:00am, Licensing Program Analysts (LPAs) L. Hall and Ardalan Gharachorloo conducted an unannounced Case Management visit regarding an request for change of Administrator that was submitted to CCLD on 7/9/2024. LPA met with Nida Acosta, Direct Support Professional. Administrator, Ryan Carvajal, arrived at 10:50am and explained the purpose of the visit.

LPA L. Hall while received the request to change the Administrator; however, there were not any documents attached. LPAs conducted the visit to confirm facility has an certified administrator. The facility does not have a certified administrator at this time.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. A copy of the appeal rights and this report provided.