Facility Evaluation Report

Licensing Program Analyst (LPA) conducted a case management visit to issue deficiencies observed during a complaint investigation on 5/30/23. LPA met with administrator, Elna Villaflor, to explained the purpose of this case management.

During the complaint investigation for control #28-AS-20230522100241, LPA observed some deficiencies pertaining to the admission agreement. Per observation of Resident #1's (R1) records, the admission agreement was missing the basic rate fees and/or fees for any level of care, although it was signed by the responsible party. In addition, the refund amount was not issued within 15 days after the personal property was removed. R1 passed away on 2/28/23 and Resident #1's (R1) family was issued the refund on 4/26/23.

Based on information gathered, the deficiencies are issued on the LIC809D. An exit interview was held and a copy of this report along with appeal rights was given to the administrator.