Facility Evaluation Report
On 01/19/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted a case management inspection visit at this facility. LPA met with Shannon Hamling and explained the purpose of the visit.
During aN initial complaint inspection visit on 01/18/23, LPA observed on Personnel Report LIC 500 staff #1 (S1) Jazmin Gonzalez Licensed Vocational Nurse on scheduled Monday - Friday 6am - 2pm. (S1) has criminal clearance background, however, (S1) is not associated employee at this facility. The facility is in violation of
In review of client's files, LPA identified two of the three clients are over the age of 60 years. Client #1 (C1) was admitted on 06/09/19 and Client #2 (C2) was admitted on 05/29/19. The facility is retaining clients over 60 years and must must submit a Age Exception from Community Care Licensing (CCL) for (C2). The facility is in violation of 85068.4 Acceptance and Retention Limitations.
California Code of Regulations (Title 22, Division 6, Chapter 1), deficiencies were observed, and citations were issued (ref. LIC 9099-D).
An exit interview was conducted and a copy of the Evaluation Report and Appeal Rights were provided to Shannon Hamling.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction