Facility Evaluation Report

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced case management visit due to the deficiencies noted during a visit to the facility today.

Per review of 3 out of 6 residents' facility file, Resident files are incomplete. Resident #1 does not have an Admissions Agreement, Identification and Emergency Information(LIC601), Resident #2 does no have Appraisal/Needs and service. Resident #3's hospitalization on 5/20/23 was not reported to licensing

Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8

Exit interview was conducted, Appeals Rights discussed and a copy was provided.