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 07/19/2024. LPA was greeted and granted entry into the facility by Caregiver Marinell Bautis and explained the reason for the visit. Jay Pichika arrived during the visit.

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

*Deficiency cited under H & S Code 1569.626(a)(1) pertaining to Dementia Training has been cleared. Licensee provided proof of training.. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87467(a)(1) pertaining to Care Plans has been cleared. Licensee provided proof of correction.. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87411(c)(1) pertaining to CPR has been cleared. Licensee provided proof of correction.

Licensee to provide documented plan of completion for renovation by 09/23/2024.

Licensee has been advised to maintain all items in compliance with Title 22 regulations.

Exit interview conducted and a copy of this report was left at the facility.