Facility Evaluation Report
Capacity6
Census4
Date signed01/06/2023 09:30:00 AM
At 9:00am, LPA conducted an unannounced Case Management Visit to this facility. LPA met with the Administrator and explained the reason for the visit. Entrance interview conducted.
After review of complaint #31-AS-20221215161509, a deficiency was issued on 12/20/2022. In addition, on 05/26/22 the facility was issued another deficiency for the same violation and it had been determined that a civil penalty should be assessed.
During todays visit a Civil Penalty was issued.
Exit interview conducted, appeal rights explained and copy of this report provided to the Administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction