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 07/18/2025 and 08/05/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit.

*Deficiency cited under Title 22 Regulation 87464(f)(1) pertaining to Basic Services has been cleared. Licensee provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87303(a) pertaining to Maintenance and Operation has been cleared. Licensee provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87355(e)(2) pertaining to Background Clearance has been cleared. Licensee provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87204 pertaining to Limitations- Capacity and Ambulatory Status has been cleared. Resident has been moved to the first floor. Licensee has complied with the terms of the POC.

*Deficiency cited under H & S Code 1569.17(c)(1)(A) pertaining to Finger Print Clearance has been cleared. Licensee has provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87303(c) pertaining to Window Screens has been cleared. Window screen has been repaired. Licensee has complied with the terms of the POC.