Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Case Management visit on 1/30/25 at 9:50am and met with Artemio Gordulan, Caregiver and stated the purpose of the visit.

LPA observed that S1 and S2 both completed required training's and is fingerprint cleared. However, S2 is not associated to the facility on LIS nor Guardian. A copy of the rosters were provided to the caregiver during this visit.

Based on LPAs observations, records review from regional Center and Facility, and interview with Caregiver the preponderance of evidence standards has been met.

Per California Code of Regulations, Title 22 Division 6, Chapter 6, deficiencies are being cited during this visit. If any deficiencies are not corrected by the noted due dates; civil penalties may be assessed. The Administrator was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights. Exit interview held, Appeal Rights discussed, Copy of report given.