Facility Evaluation Report

On 1/26/23 at 2:40 p.m., Licensing Program Analyst (LPA) Catherine Lin conducted case management, met with staff, and explained the purpose of visit.

During the course of investigation on a complaint, the Department observed the following deficiencies.

· Staff did not update needs & service plan (LIC625) when R1's health condition was changed.

· Staff did not have care note for resident health condition change.

Deficiencies are cited per Title 22 California Code of Regulations. Please refer to LIC 809D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty.

Exit interview conducted with staff and Administrator over the phone, Appeal Rights and a copy of this report were provided.