Facility Evaluation Report

Licensing Program Analysts (LPAs) Anna Bueno and Michelle Echeverria conducted an unannounced visit to this facility regarding a report of capacity limitations. LPAs met with staff Diego Blanco and Jay Ruby, house manager. The following is a summary of the incident:

On 1/05/2023, LPA Anna Bueno received a call from administrator (AD) Sachin Mathur regarding Client 1 (C1) that was placed in the home. LPA advised AD to submit an LIC 200 to request a capacity change. The Department received the LIC 200 on 1/11/2023 requesting for a capacity change.

Refer to LIC809-D for deficiency cited. An exit interview was conducted where this report (LIC 809), LIC 809-D, LIC421IM, and appeal rights were discussed, and copies were provided to Jay Ruba