Facility Evaluation Report

Licensing Program Analyst (LPA) Yolanda Delgado conducted case management to check on the Health & Safety of the residents in care. LPA conducted walk through the facility accompanied by Resident #1 (R1), LPA observed six (6) residents at the facility, working utilities, perishables and non-perishables observed, medications, sharps and toxins were not locked, not stored and readily accessible to residents in care.

LPA contacted Licensee/Administrator Florence Mojica and it was stated the live-in caregiver had an emergency and left the facility and she was notified at 10:15 that the caregiver was seeking medical attention. LPA to stand by for Licensee/Administrator. Licensee/Administrator arrived during the visit, during interviews it was determined that there are concerning issues and an Informal Office meeting will be scheduled with Florence Mojica to address concerns and change of Ownership information that was provided on this day.

The facility will be cited Title 22, Division 6, Chapter 8, Article 08, Section 87464(c), Article 05, Section 87309(a), Section 87303(g), Article 02, Section 87109 (b) with Civil Penalties that will be issued for a total of $1,000.

An exit interview was conducted with Florence Mojica and a copy of this report, LIC809D, LIC421IM and Appeal Rights was provided.