Facility Evaluation Report

On 2/3/2023 at 10:00 am, Licensing Program Analyst (LPA) Jamie Ivey Canady conducted an office meeting with facility administrator Jennell Revera regarding reporting requirements.

LPA Ivey Canady explained the reason for the meeting. LPA discussed facility incident reporting requirements based on Title 22 Regulations.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 809D during this meeting.

If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed. The Licensee was provided a copy of their rights (LIC9058 3/22) and their signature on hard copy via email acknowledges receipt of these rights.

An exit interview was conducted, and a copy of this report was emailed to administrator Jenele Revera.