Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with House Manager, Stephanie Harmon-Christensen, to conduct a health and safety check.

During visit, LPA received and reviewed proof of corrections and cleared deficiencies. LPA observed a 60-day notice provided to resident (R1) and observed notice to be unlawful per Health and Safety code.

The facility currently does not have a certified administrator. A civil penalty in the amount of $600 was assessed for today's date due to failure to correct a citation regarding obtaining a certified administrator. Another civil penalty in the amount of $600 was assessed for today's date due to failure to correct a citation regarding issuing a refund to a resident's authorized representative following their death.

As a result of today's inspection, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on 809-D.

Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.