Facility Evaluation Report
On 11/01/23 from 9:00 am to 10:00 am, Licensing Program Analyst( LPA) Ernand Dabuet initiated a Collateral visit at this facility. LPA met with Executive Program Director Pat Ball. LPA explained the purpose of this visit is to gather information regarding a current complaint about California Mentor-Dominquez Home Complaint number 11-AS-20231023140847.
The visit consisted of an interview with Pat Ball staff #1 (S1) to discuss the incident that happened with (C1) on 09/26/23 at the California Mentor-Dominquez Home. Details on the interview are documented on LIC 812 crossed reference with California Mentor-Dominquez Home #198602255. (C1) was not the day program during the visit and no interview was available.
During the visit, LPA requested copies of (C1's) service records.
An exit interview was conducted with Pat Ball, and a hard copy was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction