Senior Care Records.

Facility Evaluation Report

A&a Health Services San Pablo, San Pablo05/29/2024Licence 079201030

Capacity225
Census123
Date signed05/29/2024 01:40:43 PM
The inspector’s account

On 05/29/24 at 09:50 AM, Licensing Program Analysts (LPAs) Carol Fowler and Tonica Syess-Gibson arrived unannounced to conduct a case management. LPAs met with Shanda Thompson Williams, Case Manager, and explained the purpose of the visit.

On 05/26/24, LPA received an LIC624A regrading the death of Client 1 (C1). LPAs reviewed C1’s files, interviewed Kayla Sardenga, Operations Manager requested and received documentation including but not limited to relevant incidents that may have occurred prior to C1’s death, case notes, most recent Physician’s Report/Medical Assessment, Preplacement Appraisal, Medication List, ID/Emergency contact information and requested Official Death Certificate to be submitted by June 18, 2024.

Exit interview conducted and a copy of this report provided.

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