Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit in conjunction with a plan of correction visit (POC). LPA was greeted and granted entry into the facility and explained the reason for the visit.

Upon entry, LPA observed two staff present are not cleared or associated to facility. During the POC visit, LPA observed a broken kitchen cupboard, tile buckling on floor by front door, and a large pile of debris in the yard.

LPA consulted with Licensee regarding staffing. Licensee indicates two staff will be arriving in the evening to work. LPA verified that both staff are cleared and associated to the facility. Licensee to forward a copy of the LIC 500 by close of business 09/23/2024.

Licensee has been advised a meeting will be scheduled at the Orange County Regional office to discuss facility non-compliance.

Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with facility representative.