Facility Evaluation Report

Licensing Program Analyst (LPA) Salia Walker conducted an unannounced Case Management-Deficiencies inspection visit at the facility today due to deficiencies observed during the subsequent visit of complaint control # 29-AS- 20210628101044.

At 08:39 a.m., the LPA identified there were two (2) staff to 5 residents. The staff #1 (S1) claimed that they have been working at the facility for ‘one month’. The LPA confirmed that this individual was not associated to this facility. At 9:00 a.m., it was revealed through interview with Administrator and identification verification that staff #2 (S2) was also not associated to this facility.

Pursuant to Title 22 of the California Code of Regulations, the following deficiencies were cited (refer to LIC 809-D).

Exit interview conducted, today's reports and appeal rights were reviewed and issued.