Facility Evaluation Report

Licensing Program Analysts (LPA) Leslie Ngo-Castaneda met with facility administrator Sousan Ayyad for a Plan Of Correction (POC) visit.

The purpose of the POC visit is to make sure deficiencies were corrected on reports issued on 10.22.2024.

LPA toured the home and requested the following:

-CCR 82068(b)(1); 82068(b)(2) ; 82068(b)(3) ; 82068(b)(3)(A); 82068(b)(3)(B); 82068(b)(3)(C); 82068(b)(3)(D) - Missing admission agreement; 82068(b)(3)(E); 82068(b)(4) ; 82068(b)(5); 82068(b)(6); 82068(b)(7); 82068.2(b); 82068.2(f)(1)(C); 82068.2(f)(2); 82069(a); 82070(b)(8); 82070(b)(11)- Clients Records.

POC: Based on record review, the licensee did not comply with the section cited above in 1 count out of 1 documents in client chart which poses/posed a potential health, safety.

POC date 12.5.2024: POC Cleared during LPA visit.