Facility Evaluation Report
Capacity6
Census0
Date signed05/17/2022 02:44:32 PM
On 5/17/22 at 12:30 PM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a case management - other inspection. R1 now resides at Divine Mercy Guest Home IV #157206697. LPA conducted inspection and interview at Divine Mercy Guest Home IV.
On 2/4/22, CCL received an incident report concerning R1. LPA conducted interview and reviewed records. Due to time constraints, LPA will return to continue the case management inspection.
Exit interview conducted. A copy of this report was provided to Licensee Susan Baal, whose signature confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction