Facility Evaluation Report

On 07/08/22, Licensing Program Analyst (LPA) Ernand Dabuet initiated a Case Management visit. LPA was met by Shalani Ramos the assistant administrator and explained the purpose of today’s visit.

LPA toured the physical plant in association with the required annual inspection on 07/08/22. The facility is caring for residents diagnosed with dementia and observed the residents with non-up-to-date medical assessment and reappraisal reports for residents #1- #4 (R1–R4). The physician's reports for (R1) is dated 02/05/21 and (R2) is dated 06/08//21. While (R3) and (R4) are dated 10/06/20. During the inspection, LPA observed that the facility did not have a current administrator on file and did not notify the Department of the change of administrator. During record review, an active administrator was observed for Rodrigo Ramos which is not in compliance with PIN 21-24 CCLD.

Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8,

Deficiencies are issued and an exit interview is conducted with Shalani Ramos. A copy of this report is provided along with the appeal rights.