Facility Evaluation Report

Licensing Program Analyst (LPA) Katie Brown arrived unannounced at the facility and conducted a Case Management visit with Brittany Castaneda.

During the facility visit, LPA discovered that two (2) staff who were present at the time of the visit were not associated to the facility.

See attached 9099D for citation issued in accordance with California Code of Regulations Title 22. An immediate civil penalty of $500 is assessed for each individual that has not been associated to the facility. The issuance of additional civil penalties is pending and currently under review. The details of additional civil penalties will be outlined in a future report to the facility, if any.

The following deficiencies were observed and noted on the attached LIC 809D. All violations that, if not corrected, will have direct and immediate risk to the health, safety or personal rights of clients in care.

An exit interview was conducted, and a Plan of Correction was developed and reviewed. A copy of this report and appeal rights were discussed and left with Brittany Castaneda, whose signature on this form confirm receipt of these documents.