Facility Evaluation Report

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to complete a POC visit in concerns to the annual inspection on 10/02/24. LPA met with licensee Baby Quintero during today's inspection.

During today's inspection LPA reviewed POC's that were due by 10/18/24. LPA assessed civil penalties for the following deficiencies:

Post the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475). Although licensee posted the poster, it was not the correct size 20” x 26”.

Complete a needs and service plan for R1 and R2. Licensee submitted an incomplete needs and service plan, and only completed and sent 1 page.

Complete a statement of understanding and send the plan into LPA. Licensee did not send a statement of understanding for regulation 87506.

Licensee sent in a infection control plan on 10/17/24, however licensee did not complete the plan properly. Licensee agrees to complete the infection control plan on form LIC9282 and send a copy into LPA by 11/4/24.

Licensee agrees to complete POC's by 11/4/24 and send into LPA.

Civil penalties assessed. Exit interview conducted.