Facility Evaluation Report

On 01/14/25, Licensing Program Analyst (LPA) M. Yang arrived to unannounced to conduct case management deficiency visit and met with Administrator Douglas Rice.

During the course of the investigation for complaint 24-AS-20240911151955, staffs were interviewed during the complaint investigation. Five staff that were interviewed were found not to be associated with the facility during the time of the complaint investigation.

A deficiency is being cited and an immediate Civil Penalty were assessed. See Lic 421BG is being cited on

the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6.

Exit interview conducted. A copy of this report and appeal rights was provided to Administrator, whose

signature confirms receipt of this report.