Facility Evaluation Report

On 3/10/2023 at 4:50 PM, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct a case management visit to verify if an individual is currently employed at the facility. LPA met with Eva Penas and explained the purpose of the visit. LPA spoke with Administrator Belen Rodriguez on the phone. Administrator authorized staff Eva Penas to sign the report.

LPA interviewed Administrator and caregivers Carmen Roxas and Eva Penas. Based on evidence obtained during today’s visit, the LPA has verified the individual is not present, employed or residing at the facility. Administrator states the employee has not been working at the facility since July 20, 2019. LPA has advised the Administrator to disassociate the individual from their roster and submit an updated LIC 500.

LPA provided Eva Penas a copy of Immediate Exclusion Letter.

Exit interview was conducted and a copy of this report was provided.