Facility Evaluation Report

Mori Manor, San Leandro08/31/2023Licence 019201054

Capacity14
Date signed08/31/2023 05:09:42 PM
The inspector’s account

On this day, August 31, 2023, a Non-compliance Conference was conducted. The existing deficiencies, problem areas in the operation of the facility, civil penalties, repeat violations and failure to submit proof of corrections were discussed.

2. Licensing Program Manager (LPM) Jeremy Fong

3 Licensing Program Analyst (LPA) Alicia Delmundo

Deficiency is cited from Title 22 California Code of Regulations for administrator qualification.

Additional civil penalty is issued on this day for failure to submit proof of corrections by plan of correction due date for $3M liabity insurance coverage (H&S Code 1569.605). This deficiency was cited on 7/27/23. A POC visit was conducted on 8/11/23 for failure to timely correct and with civil penalty will continue until corrected.

CP = $100.00/day x 20 days (8/12/23 to 8/31/23) = $2,000.00

Deficiency and plan of correction were discussed.

Exit interview conducted. Appeal Rights, LIC421FC Civil Penalty and copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction