Facility Evaluation Report

On 4/13/2023 at 12:05PM Licensing Program Analysts (LPAs) L. Hall and L. Alexander arrived unannounced to conduct a Case Management visit and explained the purpose of the visit.

While LPA L. Hall was conducting a complaint investigation ( 15-AS-2023040711291 ) on 4/13/2023, upon arrival LPA observed medication in a small container sitting on kitchen table.

-At 9:38AM, LPA observed medication in a small container for C1 sitting on kitchen table.

The deficiency was observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiency and/or repeat deficiency in a 12-month period may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided