Facility Evaluation Report

On this day, 7/15/25, at 11:4 Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a case management health and safety check as a result of a complaint (15-AS-20250711090435 ) received by the Department. LPA was granted entry by Teresa Casl, staff. LPA spoke over the phone with Mary 'Rose' Malekamu Mataele, administrator (ADM) and informed the reason for visit. ADM stated she can not come to the facility to meet with LPA and gave permission to Teresa Taal to be with LPA during inspection and to sign and receive this report.

LPA toured the facility inside out with staff.

-at 12:22 pm, shovels and hospital bed in the backyard and soiled mattress and foam in the side yard.

-at 12:23 pm, the following in the side yard: pails of paints; unlocked storage with tools and cleaning agents (409; broken door; hospital beds headboards

Deficiencies are cited from Title 22 California Code of Regulations and listed on 9099Ds. 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,

LPA called and left message on ADM's voicemail and informed of the deficiencies observed and plan of corrections. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided to Teresa Caal.