Senior Care Records.

Facility Evaluation Report

Luna's Home, San Rafael03/20/2023Licence 216803707

Capacity4
Census3
Date signed03/20/2023 02:32:05 PM
The inspector’s account

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of conducting a Annual Continuation. LPA was greeted at the door by Caregiver, Shella Pastore, and was granted access into the facility.

During this Case Management-Annual Continuation, LPA interviewed staff and residents in care. LPA reviewed staff and resident files during this Case Management-Annual Continuation. LPA requested the following documents to be sent:

LIC 400- Affidavit regarding Client Cash Resources

Updated Emergency Disaster Plan (LIC 610E)

No deficiencies were cited during this Required 1 year inspection. Exit interview was conducted and a copy of this report was signed and given to the Caregiver.

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