Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit in conjunction with complaint visit 22-AS-20230414121958. LPA was greeted and granted entry into the facility and explained the reason for the visit.

During the course of the complaint investigation, LPA reviewed the admission agreement for Resident 1 (R1). R1 admitted into the facility via Adult Protective Services on 03/09/2023. While resident was acclimating to the new environment, admission agreement was not signed until 04/17/2023. Facility indicates inadvertent error with the signing of the admission agreement.

Based on the observations made from today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the Administrator and a copy was emailed to Administrator as well as Appeal Rights.