Facility Evaluation Report

Licensing Program Analyst (LPA) Stephanie Cifuentes conducted a Case Management visit in relation to incident report regarding client#1 that was reported via fax to CCL on 3/14/2022. LPA met with house manager Uila Sekona and discussed the purpose of the visit.

During todays’ visit LPA reviewed the file of client #1, interviewed manager and staff 1 (S1). Per manager 3/13/2022 client #1 was standing in driveway then proceeded to walk into the street, where they were struck by car.

LPA requested for house manager Uila to fax the following documents to licensing as facility has no copy machine: IPP, needs and services appraisal, facility file for S1.

No deficiencies will be cited at this time, additional investigation is required which includes analysis of the records obtained and follow up interviews.

Exit interview held and a copy of report provided to Manager Uila Sekona