Facility Evaluation Report

An Office meeting was conducted today in the Santa Rosa Regional Office. The following individuals were present in the meeting: Licensing Program Manager, Bethany Moellers, Licensing Program Analyst, Shannan Hansen, Licensee/Administrator, Elizabeth Allen, and Crystal Leser, Assistant Administrator. The purpose of the office meeting was to hold an informal meeting to address areas of concern identified by the Department. The following areas were discussed during the meeting today:

· Administrator Qualifications and Duties

Parties discussed the recurrence (12/16/2022 by LPM Bertozzi & 9/2/2025 by LPA Hansen) of bedridden residents admitted to facility without approved Fire Clearance. 2022 and 2025 Fire Department advised change to obtain bedridden clearance. To date licensee confirmed changes have not been completed. Licensee agrees to inform CCL intent of moving forward with bedridden STD850 request no later than 11/12/2025.

No Deficiencies Cited during office meeting.

Exit interview conducted. Copy of report discussed and provided to Licensee and Applicant. Signature on form confirms receipt of documents.