Facility Evaluation Report

On 03/02/2025 Licensing Program Analyst (LPA) T. Syess-Gibson was conducting a complaint investigation (15-AS-20250304134220). During record review and interview, LPA observed licensee did not submit any Special Incident Reports (SIRs) to CCL regarding staff left resident unsupervised for an extended period of time in December 2024.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties .

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