Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Licensee, Aida Briones, to follow-up regarding documents received during a separate inspection conducted on December 11, 2024.

During visit, LPA reviewed resident (R1's) documents on file at the facility. LPA observed that Physician's Report LIC 602A on file for R1 did not belong to R1 but to another individual. LPA requested a copy of R1's LIC 602A on file. Facility was unable to provide an LIC 602A for R1 on file by the conclusion of LPA's visit.

LPA obtained a signature from Licensee regarding an amended report for inspection conducted on December 11, 2024.

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 pages.

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