Facility Evaluation Report

On 04/25/2025, Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced Case Management visit to gather additional information regarding a complaint that was reported to Community Care Licensing received on 04/18/2025, Control #11-AS-20250418112036. LPA met with Kaywanee Sorrells, Health Services Director, and explained the purpose of the visit.

On 04/25/2025, the Department asked for copies of the following documents: Resident 1 (R1) Record, Admission Agreement, Identification and Emergency Information, Physician's Report, Medical Assessment, Medication Administration Records (MARs), Consent Forms, Functional Capability Assessment, Special Incident Reports, USC Verdugo Hills Psychiatric Hospital Records, Preplacement Appraisal Information, Appraisal, Needs and Service Plan.

During today's visit, Resident 1's records were unavailable for review during the complaint visit.

According to the California Code of Regulations, Title 22, Division 6, Chapter 8, the Department observed the following deficiency, the facility is being cited on the attached LIC809-D.

Appeal rights were discussed, and copies of the LIC809, LIC809-D, and appeal rights were provided to Health Services Director Kaywanee Sorrells.