Facility Evaluation Report
Capacity6
Date signed12/20/2022 02:52:04 PM
Licensing Program Analyst (LPA) Angela Panushkina conducted an unannounced case management visit at this facility to issue deficiency in conjunction with complaint control # 31-AS-20221215161509, wherein during the course of investigation regarding this complaint, LPA observed the following:
Upon arrival, LPA checked Licensing Information System (LIS) and observed Staff #1 and Staff #2 were not fingerprinted and or associated with this facility.
Citation issued on LIC809-D and appeal rights discussed.
Exit interview conducted. Copy of this report issued
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction