Facility Evaluation Report

On 12/9/2021 at 9:10 a.m. Licensing Program Analyst (LPA) , Nina Galarza conducted an unannounced Case Management visit. Purpose of the visit was to address deficiencies observed during an inspection. The purpose of this visit was explained to Program Manager, Christopher Young. Provider Relations Specialist, Juan Burmudez from Harbor Regional Center was also present during this visit.

Staff#1(S1) and Staff#2 (S2) at the facility, but not associated to the facility.

Front door chime, medication door chime, and sliding door chime in client bedroom #3 not turned on

Dresser in client bedroom #3 in disrepair

Patio chairs in backyard area in disrepair

Trashcans filled with dirt blocking walkway in back yard

A mop, broom and water hose blocking walkway in backyard

Civil Penalty in the amount of $1000 is being assessed today.

Deficiencies cited under California Code of Regulations, refer 809-D

Exit Interview conducted, copy of report and appeal rights provided.