Facility Evaluation Report
On 10/21/2024 at 9:00 AM, Licensing Program Analysts (LPAs) James Sampair and Ardalan Gharachorloo conducted a Plan of Correction (POC) inspection. Upon entry into facility, LPAs explained the purpose of the visit to Licensee Ericka Tillis.
The Licensee failed to send documentation of POC clearance from the citation issued 10/10/2024 to LPA Sampair. During the inspection of the facility, the medications were in locked storage, however, the signage on the first and second floors was not posted.
Per Title 22 California Code of Regulations, a $1,100.00 Civil Penalty was assessed for the repeat of a prior violation of Section 87309(b) first issued on 9/24/2024 that was due on 10/11/2024. For additional details, refer to the LIC 421FC form. Failure to submit proof of corrections may result in additional civil penalties.
Exit interview conducted, a copy of this report, and the appeal rights were provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction