Facility Evaluation Report
Capacity6
Census5
Date signed08/07/2023 12:47:11 PM
LPA Spaeth conducted an unannounced visit regarding Complaint 31-AS-20230801095955 and confirmed there are five residents living within.
LPA reviewed residents' records at 10:40 am until 11:15 am. LPA observed the residents' records were incomplete.
Pursuant to Title 22 Division 6 of the CA Code of Regulations, a deficiency was cited (refer to LIC 809-D).
Exit interview conducted, Appeal Rights discussed, and a copy of the report was issues to Administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction