Facility Evaluation Report

This unannounced case management visit is being conducted by Licensing Program Analyst (LPA) Ruth Martinez. LPA arrived at facility was greeted and granted entry by caregiver. Michael San Diego, Administrator arrived shortly after and met with LPA. LPA explained the nature of the visit to Administrator.

LPA Martinez is conducting this visit in response to an incident report of possible personal rights violation for C1. Incident was self reported on May 05, 2022 regarding C1’s incidents on May 04, 2022. This visit is being conducted for the purpose to review and collect facility records.

During today’s visit, LPA took a tour of the facility physical plant, completed a review of clients records, completed a review of staff records and obtained copies of pertinent documents.

This report was reviewed with Administrator and a copy of the LIC809 and LIC811 was provided and left at the facility.