Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted a case management visit during a complaint investigation visit for deficiencies observed (complaint # 28-AS-20250829113624). LPA Flores met with Administrator Shawn Bailey and explained the reason for the visit.

During complaint investigation the following deficiencies were observed:

- LPA observed that S2 was not associated to facility and during interviews with S1 and S3 it was revealed that S2 does sometimes assist with care and supervision at facility when staff is needed as they are a staff at a sister facility.

- LPA reviewed pest control servies that are being provided at the facility and they revealed that on 8/14/25 carpet beetle larva was found in 2 bedrooms and treatment was provided in area and the living room was also treated for bed bugs.

Deficiencies will be cited on the LIC 809-D page per Title 22 regulations. Exit interview was conducted with held and a copy of this report, 809D, and appeal rights were provided.