Facility Evaluation Report
Capacity6
Census5
Date signed03/12/2024 05:19:56 PM
This case management visit was conducted in conjunction with complaint control number 31-AS-20240308160649 to address the deficiencies unrelated to the complaint allegations.
On 3/12/24 at 3:00pm, during complaint investigation LPA Valenzuela and LPM Margaryan were informed that the Licensee/Administrator does not have facility file for Resident #1 (R1).
No documents were available for Licensing agents to review.
Therefore, under Title 22 Regulations, the following deficiency was cited and recorded on LIC 809D.
Exit interview conducted and a copy of the report was issued.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction