Senior Care Records.

Facility Evaluation Report

Country Place Assisted Living, Antioch06/14/2023Licence 075601547

Capacity49
Census38
Date signed06/14/2023 02:10:23 PM
The inspector’s account

On 06/14/23 at 2PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an unannounced health and safety check case management visit. LPA explained the purpose of the visit with administrator (ADM).

During the health and safety check, ADM confirmed with LPA that resident (R1) is adjusting well in the community since admittance on 06/06/23. ADM stated R1 started playing domino's and cards with two other residents in the activities room. LPA observed R1 comfortably resting inside his bedroom and that there is no imminent health or safety concerns on today's date.

No deficiencies cited during the health and safety check. Exit interview conducted and a copy of this report provided.

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