Facility Evaluation Report

On 9/6/2024 at 02:05pm, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a Case Management visit. LPA met with Wilfredo Bacani, Caregiver, and explained the purpose of the visit.

While LPA L. Hall was investigation complaint ( 15-AS-20240212113726 ) and delivered findings on 9/6/2024. During record review LPA observed R1’s file was not available for review and facility did not report R1's incident to CCLD.

*An immediate civil penalty of $500.00 will be assessed on today's date*

Deficiencies are 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