Facility Evaluation Report
Licensing Program Analyst (LPA) made an unannounced case management visit to return resident records listed on the Confidential Names Report (LIC 811). LPA was greeted and granted entry by Adora Capa, staff at 2:56pm.
Per California Code of Regulations 87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying.
L PA returned five of five resident records which include: Identification and Emergency Information forms (LIC 601), Physician's Reports (LIC 602A), Resident Appraisals (LIC 603A), hospice paperwork and Admissions Agreements. Staff member, Adora Capa, confirmed receipt of the original documents for five of five residents.
An exit interview was conducted with Adora Capa and a copy of this report and LIC 811 were provided to the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction