Facility Evaluation Report
Capacity4
Census3
Date signed07/03/2024 04:21:40 PM
In conjunction to the complaint number 31-AS-20240628090950 Licensing Program Analyst (LPA) Mariana Agban conducted a case management- Deficiencies visit. LPA received a Special Incident Report from S2 regarding an incident on 3/10/24. S2 reported that facility staff failed to report the incident to S2 in a timely manner and thus S2 submitted the Special Incident Report to CCL promptly.
Exit Interview Conducted. Deficiencies Cited. Report Issued
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction