Senior Care Records.

Facility Evaluation Report

Providence Residential Home, Northridge12/02/2022Licence 197610200

Capacity4
Census4
Date signed12/02/2022 03:26:54 PM
The inspector’s account

Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced case management visit to this facility to cite deficiencies discovered during the course of investigating a complaint 31-AS-20221028145528.

LPA met with administrator Moses Wakabi and explained the reason for the visit. During the complaint investigation, while reviewing facility documents on 11/07/2022 and 11/08/2022, LPA found out that the facility had no signed admission agreement with Client #1 (C1) on file. LPA interview with the administrator on 11/07/2022 confirmed that C1 had no signed admission agreement on file. LPA confirmed with North Los Angeles County Regional Center (NLACRC) an admission agreement was not signed on behalf of C1.

Deficiencies issued (refer to 809D). Appeal right provided. Exit interview conducted. Copy of this report issued.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction