Senior Care Records.

Facility Evaluation Report

California Mentor - Dominguez Home, Carson10/06/2021Licence 198602255

Capacity3
Census3
Date signed10/06/2021 06:32:05 PM
The inspector’s account

On 10/05/21, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced case management visit at this facility. LPA was greeted by registered nurse Linda Smith and explained the purpose of the visit is in association with the health and safety check visit conducted on 09/28/21.

During the inspection visit on 09/28/21, the administrator revealed that client #1 (C1) is in the process of being relocated to another licensed facility. The Area Director Jeri Miles had sent out a Notice to (C1's) family representatives and Harbor Regional Center Service Coordinator effective 08/16/21. The notice indicated Harbor Regional Center has not been able to locate a new residence for (C1) and therefore California Mentor will be extending the 30-day discharge notification. The management failed to cross-report this information with Community Care Licensing Division on LIC 624. The deficiency requires the assessment of a citation. This act is a violation of Title 22, Division 6 Chapter 1.

A citation is issued, civil penalties assessed, and an exit interview conducted with Linda Smith.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction