Facility Evaluation Report

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to the facility to conduct a case management visit on the health, safety, and welfare of residents in care. LPA met with Therapist, Christopher Merritt. LPA was informed that thirteen (13) residents currently reside at this facility. Thirteen (13) residents were at the facility at the time of the inspection. There were five (5) staff members on duty, during the time of the visit.

LPA toured the facility and observed all facility utilities to be on and operating without issue, food supply is sufficient, there is no immediate concern for residents in care. LPA obtained the resident and staff roster and ensured all staff was background cleared.

Based on the information obtained during today’s visit, there are no deficiencies or civil penalties being cited per California Health & Safety Code and Code of Regulations, Title 22, Division 6. An exit interview was conducted with Therapist, Christopher Merritt and a copy of this report is left with the Facility representative, as evidence by his signature.