Facility Evaluation Report

On 06/10/2024 at 01:00 PM, Licensing Program Analyst (LPA) Melody Brown met with Staff #2 (S2) to initiate a Case Management Visit. The investigation consisted of observation, interviews, and a review of pertinent documentation.

During the facility visit on 06/10/2024, Licensing Program Analyst (LPA) Melody Brown requested Client #1 (C1) facility file to review documents and LPA Brown observed that C1 does not have Physician Report (LIC602)/Medical Assessment on C1’s facility file. S2 contacted Administrator Melanie Morris to inquire on C1's Medical Assessment or Physician Report (LIC602) whatever is available when C1 was placed at the facility by Inland Regional Center (IRC). LPA Brown explained to Administrator Morris and S2 that deficiency will be issued as in Adult Residential Facility (ARF), the Licensee must obtain and keep on file documentation of the client’s medical assessment prior to accepting client into care. Administrator Morris and S2 verbalized understanding. Administrator Morris and S2 reported to LPA Brown that they will provide a copy of C1 Medical Assessment once it's available. Also, Administrator Morris and S2 reported that C1 was placed at the facility on 03/29/2024.

Moreover, LPA Brown observed no Admission Agreement completed on C1's facility file. LPA Brown explained to Administrator Morris and S2 that deficiency will be issued as the Licensee's required to complete an individual written admission agreement for C1 and C1's authorized representative, if any. S2 and Administrator Morris verbalized understanding.

An exit interview was conducted where this report (LIC809), LIC809D and Appeal Rights were discussed and provided to staff Princess Bowen.