Facility Evaluation Report
Capacity6
Census5
Date signed11/16/2023 12:20:43 PM
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced Case Management visit. LPA met with facility Administrator, Lisa Pua and explained the purpose of the visit.
LPA Hurt collected records for Resident 1 including Physician's report, Needs and services plan, and care notes. LPA Hurt reviewed Resident 1's Physician Report which is more than 3 years old. Resident 1 should have a Physicians report updated annually.
The following Deficiencies are being cited Per Title 22 Regulations.
Exit interview conducted with Administrator, Lisa Pua, and a copy of this report along with appeals right provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction