Facility Evaluation Report
On 9/6//23 at approximately 3:30PM Licensing Program Analyst (LPA) Jennifer Fain arrived at the facility unannounced to conduct a case management. LPA met with administrator and explained the reason for the visit. The facility is licensed for 6 residents and currently has 6 residents in care.
Based on LIC500, requested 8/30/23 and received 8/31/23, LIS Facility Personnel Printout and Guardian Employee Roster, Staff 1 did not appear to be associated with the facility.
LPA Fain reviewed the facility files for Staff 1 and found the faxed transfer request. LPA and Administrator discussed the need to confirm Facility Profile on Guardian lists employee name.
Pursuant to the California Code of Regulations, Title 22, and California Health and Safety Code no deficiencies were cited today.
An exit interview was conducted and a copy of this report was provided to Licensee.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction