Facility Evaluation Report

At approximately 11:40 AM, Licensing Program Analyst (LPA), Julie Florio arrived unannounced to conduct a Case Management - Incident visit and was greeted by Eldimira Atilano, Caregiver/Responsible Party (RP). Licensee was telephoned and reported they were unable to be present for today's visit. Licensee did arrive at the facility at approximately 1:45 PM.

On 5/24/2024 LPA conducted 10-day follow up visit at facility to open a complaint. At which time, Licensee was unable to provide LPA with requested client (C1) records or medical follow up documents regarding the outcome of a head injury C1 sustained. Licensee submitted C1's records via email by COB 5/24/2024 and noted that they would submit proof of C1's medical visit by 5/28/2024. CCLD has not received the requested documents. LPA attempted to contact Licensee via email on 7/31/2024 and via telephone message on 8/13/2024 to provide proof of the visit and the medical outcome of both the visit and the head scan C1 reportedly had on 5/28/2024. LPA did not receive a response from Licensee. LPA is citing 80070 Client Records (a) The licensee shall ensure that a separate, complete, and current record is maintained in the facility for each client. ( See LIC809D).

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, or repeat violations within a 12-month period, may result in a civil penalty assessment. Appeal rights provided to Licensee.

Exit interview conducted with Licensee, whose signature confirms receipt.