Facility Evaluation Report
Licensing Program Analyst (LPA) Celine Rodriguez conducted an announced visit to the facility for the purpose of a plan of correction (POC). LPA explained reason for visit and was greeted and granted entry by staff on duty (S1) Fely Marcelo, who notified facility administrator (AD) Jill Bonnin about visit. AD Bonnin provided consent for S1 to receive and sign report.
On 8/15/2025, LPA observed that the Physician's Report (LIC602) for all 4 current residents were missing, therefore, facility was cited for the following: Title 22 Division 6 of the California Code of Regulations- 87458(a) Medical Assessment
As a plan of correction, facility was to schedule appointments for all 4 residents on or by 8/18/2025, to obtain a completed LIC602.
On 8/18/2025, AD Bonnin provided LPA the LIC602s for all current residents.
For today's visit, LPA reviewed the resident files and observed that all resident LIC602s were completed and placed in their files.
POC has been completed and citation has been cleared.
For this visit, no citations were issued.
An exit interview was conducted with S1 Marcelo and AD Bonnin via phone. A copy of this report was provided and explained.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction