Senior Care Records.

Facility Evaluation Report

Our Lady of Guadalupe Home, Lake Forest10/20/2022Licence 306005504

Capacity6
Census3
Date signed10/20/2022 09:44:50 AM
The inspector’s account

Licensing Program Analyst (LPA) Celine De Perio made an unannounced case management visit in conjunction with the complaint: 22-AS-20220714110042.

LPA De Perio was greeted and granted entry by staff on duty (S1) Edgar Sacdalan, who contacted facility administrator (AD) Cresencia "Christine" Santiago about visit. AD Santiago was unavailable to be present, however provided consent for S1 to receive and sign reports (LIC809, LIC9099, LIC9099-C, LIC9099-D dated for 10/11/22).

For this visit, there were a total of 3 clients in care, of which 1 was present at facility, 1 was at work, and 1 was attending Day Program.

In delivering the findings for the complaint on 10/11/22, the following concerns were found. LPA De Perio made consultation on California Code of Regulations Sections: 85068.5 Eviction Procedures

Upon conducting the investigation, it was stated that facility failed to inform Community Care Licensing with a notice of client's 30-day notice.

For the visit conducted on 10/11/22, citations were issued per Title 22 Division 6 of the California Code of Regulations, of which were given on 10/11/22 and 10/20/22 (via LIC809-D)

LPA De Perio conducted an exit interview with S1 a copy of this report, regulations discussed and specified on LIC9099-D and Appeal Rights were provided to the facility.

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