Facility Evaluation Report

On 02/11/2025 at 2:00 PM Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct a Case Management visit. LPA met with Executive Director, Jon McCraw, and explained the purpose of visit.

While LPA L. Alexander was conducting a complaint investigation (15-AS-20250205123313 ) on 02/11/2025. During record review LPA observed that facility did not notify Community Care Licensing Division (CCLD) of Resident's (R1) hospitalization. LPA interviewed Staff (S1) and S1 stated that S2 completed an incident report but did not have the receipt of date and time incident report was faxed to CCLD. LPA obtained a copy of an Incident Report that was generated by S2.

The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties.

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