Facility Evaluation Report
Capacity6
Census11
Date signed10/07/2024 02:40:05 PM
On 10/7/2024 at 1:30 PM, Licensing Program Analysts (LPAs) James Sampair and David Doidge conducted a Plan of Correction (POC) inspection. Upon entry into facility, LPAs explained the purpose of the visit to Caregiver Keiyata Pettway.
The Licensee failed to provide documentation to LPA Sampair on 3 of the 5 citations issued during the 9/24/2024 visit. Failure to send proof of correction to the LPA resulted in the issue of 3 civil penalties (for details, refer to the LIC 421FC forms).
Exit interview conducted and appeal rights provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction