Facility Evaluation Report

This Case management – Deficiencies inspection is being conducted by Licensing Program Analyst (LPA) Abdoulaye Zerbo on 1-9-25 for the purpose of issuing citations for deficiencies observed during the investigation into Complaint Control No. 18-AS-20250109153636. LPA met with Robyn Rebollar and explained purpose of the visit.

During the visit, LPA interviewed management and observed that the facility did not report the power outage to the department.

Based on observations, record review and interviews , deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809-D.

An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative, Robyn Rebollar.