Facility Evaluation Report
Capacity6
Census6
Date signed03/28/2025 02:29:21 PM
Name of licensing program analystMelissa Spaeth
Name of licensing program managerTroy Agard
Licensing Program Analyst (LPA) Melissa Spaeth conducted a complaint investigation for Complaint #31-AS-20250326141036 . During the visit, LPA reviewed the residents' files at 12:00 pm until 12:30 pm and observed the resident files were not complete.
LPA Spaeth observed Resident (R1), Resident (R2), Resident 5 (R5) were missing documentation.
Based upon LPA's observations, the following deficiencies were cited.
Exit interview conducted, appeal rights discussed, and a copy of the report was given.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction