Facility Evaluation Report

LPA Ranirez conducted an unannounced case management visit on 9/12/23 in regard to Special Incident Report (LIC 624) dated 8/27/23. LPA Ramirez was met by Staff #2 (S2) and explained the purpose of the visit. Administrator Adalid Solano-Gutierrez arrived shortly after to assist with the visit.

LPA Ramirez requested and obtained copies of client roster, staff roster, interview with staff 1 – 2, (S1- S2), copies of client#1 (C1): Identification and Emergency Information, Physician’s Report dated 6/5/23, Radillogy Report dated 8/28/23, Eastern Los Angeles Regional Center Quarterly Review Form dated 9/26/22, San Gabriel Valley Med Center discharge dated 8/27/23, Pacific Orthopaedic Medical Group Inc History and Physical dated 8/31/23, copies of Staff #3 (S3): Personnel Record, current CPR/First Aid, TB Screening, Fingerprint Clearance, and various Elwyn in-service training records.

Due to time constraints LPA Ramirez may return at a later time to gather additional documents and interviews. No deficiencies were issued and a copy of this was provided to Administrator Solano-Gutierrez.