Facility Evaluation Report
On 12/17/2024 at 11:15 AM, Licensing Program Analyst (LPA) Melody Brown met with staff Michael Jason Camarillo to initiate a Case Management Visit. Licensee/Administrator Sulaiman Durrani was contacted and informed of the visit and Licensee/Administrator Durrani designated staff Michael Jason Camarillo to sign the report as Licensee/Administrator Durrani's unavailable for the visit. The investigation consisted of interviews and review of pertinent documentation.
During the facility visit on 12/09/2024, Licensing Program Analyst (LPA) Melody Brown requested Client #1 (C1) Unusual Incident/Injury Report (LIC624) on 05/17/2024 and per document review and interview with Staff #2 (S2), LPA Brown noted that the facility did not report the manual restraint conducted my S2 to C1 to C1's authorized representative and to Community Care Licensing Department (CCLD). LPA Brown explained to staff Camarillo that deficiency will be issued.
An exit interview was conducted where this report (LIC809), LIC809D and Appeal Rights were discussed and provided to staff Michael Jason Camarillo.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction