Facility Evaluation Report
Capacity6
Census3
Date signed11/08/2022 01:41:00 PM
At 11:15 a.m. on 11/08/2022 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced, initial complaint visit of complaint #31-AS-20221108101558 . LPA met with staff and disclosed the reason for the visit. LPA and staff toured the facility at 11:25 a.m. and observed medication accessible. The medication was also removed form its original container and organized in a separate pill container.
Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the deficiency was cited (refer to LIC 809-D).
Exit interview conducted. Appeal rights discussed. Copy of report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction