Facility Evaluation Report

On 11/19/25, Licensing Program Analyst (LPA) Villegas conducted a case management visit in response to Special Incident Report submitted to CCLD on 10/23/25 for incident occurring on 10/18/25; regarding Client #1 (C1). LPA met with staff #1 (S1) Administrator Araceli Flores as the purpose of the visit was explained.

During case management visit LPA Villegas conducted a Health & Safety visit which consisted of the following: facility tour, and obtaining copies of the following records for C1: (Face sheet, pre-placement appraisal dated: 6/16/21, Physicians report dated: 11/3/25, Needs and service Plan dated: 09/30/25, Bellflower post acute post discharge plan of care dated: 11/18/25, and the copies of the client and staff rosters. LPA conducted interview with S1-S2, and attempted to conduct interview with C1 and C2 but was unsuccessful due to communication barriers. LPA unable to interview C3-C4 as clients were at Day Program.

Due to insufficient information available at this time, the above needs further follow-up.

No immediate Health & Safety issues were observed.

Exit interview conducted, and a copy of this report was provided.