Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman made an unannounced visit to the facility for the purpose of a Plan of Correction (POC) visit, based upon the deficiencies cited in LIC form 809D on 11/18/2021. LPA was greeted and granted entry into the facility by House Manager Jeanette Silva and explained the reason for the visit.

During the visit, LPA observed the following:

*Deficiency cited under Title 22 Regulation 80078(a) pertaining to Care and Supervision has been cleared. Administrator provided proof of correction.. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 80087(a) pertaining to Maintenance and Operation has NOT been cleared. Ceiling in entryway has been repaired but light needs to be fixed/ repaired. Licensee has NOT complied with the terms of the POC. Please repair light by 12/20/2021 to avoid any additional citations/ civil penalties.

Exit interview was conducted and a copy of the report was left at the facility.