Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to conduct a case management. The purpose of thee visit was to cite observed deficiencies and deliver an amended report complaint control #18-AS-20240513124312 . LPA met with Licensee, Erica Graham-Bullock, who was informed of the purpose of the visit.

LPA attempted to review records for Client #1 (C1). LPA was informed by licensee that C1 did not have medical history records, pre admission appraisal, or admission agreement for C1 and did not have a file for them. Therefore, the facility failed to keep records for C1.

During inspection conducted on June 12. 2024, LPA conducted a walk through of the home and observed (4) cameras in facility common areas. LPA reviewed the facilities admission agreements and program plan. LPA found no addendum or specification for the usage of video cameras. Therefore, the facility failed to inform the department and submit documentation as detail in Reference material 2-58000 for video surveillance.

Deficiencies were cited in accordance with California Code of Regulations Title 22 Division 6 Chapter 1. Plans of correction were created with the licensee and documented.

An exit interview was conducted where this report was reviewed and provided to Licensee, Erica Graham-Bullock.