Senior Care Records.

Facility Evaluation Report

California Mentor - Dominguez Home, Carson09/28/2021Licence 198602255

Capacity3
Census3
Date signed09/28/2021 06:11:55 PM
The inspector’s account

On 09/28/21 Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced case management visit at this facility and met with the Administrator Claudio Rosas and the Registered Nurse Linda Smith and explained the purpose of today’s visit is to conduct a plant inspection and health and safety check.

The Department had received verbal information on 09/21/21 for client #1 (C1). Details of the information brought concerns for (C1) and how his medications are being handled by this facility. LPA reviewed Medication Administrator Record (MARs) and (C1)'s service records. LPA interviewed Rosas and Smith regarding incidents 6/21/21 and 09/09/21. LPA was provided copies of pertinent information regarding (C1). Rosas states that further documents relating to (C1) will be provided by Jeri Miles the Area Director.

An exit interview was conducted, with the administrator Claudio Rosas. A copy of this report is provided by email.

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