Facility Evaluation Report
On January 9, 2025, at 8:00am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced Case Management Visit to follow-up on a death report received from the facility. LPA Kim was greeted and granted entry by Administrator (AD) Susierose Abella and LPA Kim explained the purpose of the visit. AD Abella could not stay for the visit and Direct Support Professional (DSP) Marline Agraan was given permission to sign the report in behalf of the facility.
During today’s visit, LPA conducted a health and safety check, and there were no imminent health/safety concerns observed. Facility maintained at a comfortable temperature for the residents in care. LPA obtained LIC 500, LIC 9020, and C1’s records which includes the Physician’s Report, Admission’s Agreement, Emergency Information, Consent Forms, Appraisal and Needs/Service Plan, and other pertinent documents. LPA interviewed AD Susierose Abella, Licensee, two staff members, and the Responsible Person of the client.
No deficiencies were observed during this visit.
An exit interview was conducted, and a copy of this report was provided to the Direct Support Professional Marline Agraan.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction