Facility Evaluation Report
On July 10, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit. LPA met with Caregiver and explained the purpose of the visit.
Today's visit, LPA requested R1's admission agreement as LPA has requested for the document on three separate occasion via email and/or phone call. LPA was informed by staff that R1's file was missing. LPA was unable to retrieve a copy. LPA is requesting for Administrator to submit admission agreement if there is an electronic copy stored. LPA and Caregiver discussed that all records are to be centrally stored inaccessible to others and inactive records are to be kept for three years.
LPA was informed R1 passed away two weeks ago. LPA did not receive LIC 624A Death Report for R1. Additionally, LPA was informed that Administrator visits the facility approximately every three weeks. Administrator was not present during today's visit.
LPA reviewed resident charting notes and took one photo of the notes for June 22, 2025.
Exit interview and a copy of report and appeal rights was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction