Facility Evaluation Report

Licensing Program Analyst (LPA) Yolanda Delgado conducted a case management visit on the health, safety and welfare of the clients in care as LPA was outside parked in state vehicle in front of the facility's front door awaiting for Licensee to arrive and LPA observed a male being dropped off in front of the home and male walked up to the front door and rang the Ring bell and knocked on the door; no answer at the door. LPA made contact with male and introduce herself and learned that the male was a client of the home.

(LPA) Delgado met with Erica Bullock. LPA was informed that six (6) residents currently reside at this facility, five (5) is at Day Program. The Administrator on duty during the time of the visit. Five (5) clients arrived during 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 reviewed client (C1) LIC 602.

There are two (2) deficiencies that are being cited and there are no civil penalties per California Health & Safety Code and Code of Regulations, Title 22, Division 6. An exit interview was conducted with Erica Bullock and a copy of this report, 809D and Appeal Rights will be emailed and a receipt of confirmation will be requested.