Facility Evaluation Report

On 07/30/2025 around 01:45 PM Licensing Program Analyst (LPA) L. Holmes conducted a case management in addition to complaint #15-AS-20250728094001 dated 07/28/25. LPA presented the deficiencies to Norma Tejero, Administrator.

During the course of investigation and review of R1's records, LPA observed the following:

-At 10:05 AM, interviwes with S1, S2 and S3 revealed that 24 hours notice of R1's interaction with the Richmond Police Department on 07/24/25 and admittance to Contra Costa Regional Medical Center in Martinez, California on 07/24/25 had not been provided to LPA of CCLD.

-At 10:25 AM, R1's file was incomplete: no pre-appraisal, no personal rights, no consent for medical treatment and an incomplete ID/Emergency contact information sheet.

Deficiencies cited from Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction by plan of correction due date, and any repeat violations within a 12-month period may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights were provided to Norma Tejero, Administrator.