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Facility Evaluation Report

Steadfast Western Ave, Buena Park09/15/2022Licence 306005338

Capacity6
Census2
Date signed09/15/2022 02:12:02 PM
The inspector’s account

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced case management. LPA was greeted, granted entry, and explained the reason for the visit. Staff called Administrator (AD) Abella via telephone.

The purpose of today's visit was to conduct a Case Management visit to discuss an Unusual Incident Report (LIC624) that was emailed to LPA Haley and the Orange County Adult and Senior Care Program Regional Office September 13, 2022 that involved Client 1 (C1).

AD Abella and Licensee Francine Penalosa arrived to speak with LPA Haley regarding the incident.

During the visit LPA Haley received copies of C1's Face sheet and Physician's Report. AD Abella will be emailing LPA Haley C1's Admission Agreement and Individualized Service Plan.

Deficiencies are being cited during today's Case Management visit. An exit interview was conducted, a copy of the LIC811 this report and appeal rights was provided.

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