Facility Evaluation Report
Capacity6
Census5
Date signed10/03/2024 12:14:39 PM
On 10/03/2024, Licensing Program Analysts (LPAs) M. Medina and R. Bruce conducted an unannounced Case Management visit. LPAs introduced self, stated purpose of visit, and allowed entrance by Licensee, Sheila Dillard.
LPAs conducted visit to follow up on incident reports that were submitted to this department. An incident report for R1 which occurred on 9/19/24 for R2 which occurred on 9/24/24.
LPAs reviewed resident files and requested the following documents for both R1 and R2: Physician's report and Appraisal/Needs and Services Plan and hospital discharge paperwork.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction