Senior Care Records.

Facility Evaluation Report

Cogir of San Rafael, San Rafael10/29/2024Licence 216804000

Capacity70
Census46
Date signed10/29/2024 02:43:21 PM
The inspector’s account

At approximately 11:40AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Legal/Non-Compliance visit and met Executive Director, Kimberly Humphrey.

LPA requested and reviewed documents for all employees hired from July 2024 to October 2024. Review of documents showed that facility hired 2 individuals during this time frame and has either conducted training or have scheduled training for them in the following areas:

Administrator and Designated Representatives

LPA received Administrator paperwork to update Administrator to Kimberly Humphrey. Administrator paperwork to be processed. LPA and Executive Director did a walkthrough of the facility.

Exit interview conducted. Copy of report discussed and provided to Administrator/Executive Director. Signature on form confirms receipt of documents.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction