Facility Evaluation Report
Licensing Program Analyst (LPA) B. Miranda conducted an unannounced case management visit for incident that occurred on 12/9/22. LPA met with caregiver, and Administrator (AD) Shannon Sayson arrived shortly after. The purpose of this visit is to ensure the health and safety of the residents. Facility self- reported incidents.
LPA observed 1 (R3) of the 4 residents at the kitchen table. One other residents was in their room asleep (R1). LPA interviewed R3 (please see 812 regarding interview).
LPA toured the facility inside and out. LPA observed knives, cleaning supplies, and medication as being inaccessible to residents. LPA observed 30-day supply of PPE. LPA observed sufficient perishable and nonperishable food at the facility.
AD stated he email each resident's IPP, CPI training verification for all staff, copy of LIC 500, work schedule for November and December, and copy of SIR for 12/9/22.
No deficiencies issued. Exit interview conducted with Admin. Report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction