Senior Care Records.

Facility Evaluation Report

Delta Residential-vineyards, Oakley06/14/2022Licence 079200074

Capacity6
Census5
Date signed06/14/2022 05:18:38 PM
The inspector’s account

On 6/14/2022 Licensing Program Analyst (LPA) Leslie Ibo conducted unannounced case management visit while conducting a complaint investigation. LPA informed Edwin I. the purpose of the visit.

C1 sustained less serious injury (bruises/abrasion) while in care.

Open electrical outlet observed on room 1.

Broken cabinet dresser observed on room three.

Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 9099D. Failure to submit proof of corrections (POCs) by plan of correction due dates along with the LIC9098 Proof of Correction and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided to Assistant Administrator Edwin Isip.

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