Facility Evaluation Report
On May 14, 2026, Licensing Program Analyst (LPA) Eboni Bentley conducted a case management after observing a deficiency while conducting complaint visit: 22-AS-20260504125007.
Per record review and admission, the facility admitted a resident without obtaining a Physician's Report, Admissions Agreement, and additional required records in compliance with Title 22 regulations.
Per interview with Administrator (Admin) Alan Shelley stated, the facility admitted a resident on a temporary basis of 5 days and did not obtain any written paperwork for the resident. During today's visit, LPA observed Resident #1 (R1) sitting in the common living room with three other residents. LPA also observed R1's personal belongings in R1's room that Admin previously identified as vacant.
A deficiency was cited as per Title 22 Division 6 Chapter 8.
An exit interview was conducted, and a copy of this report, LIC809-D, LIC811, and appeal rights were provided to Administrator Alan Shelley.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction