Facility Evaluation Report
Capacity8
Census5
Date signed02/21/2023 02:48:26 PM
On this day, Licensing Program Analysts (LPAs) Michelle Echeverria and Anna Bueno conducted an unannounced visit to this facility to continue investigation on complaint 56-AS-20230208144257 and initiate an investigation of complaint number: 56-AS-20230213153122, 56-AS-20230216105026 and 56-AS-20230217100751.
During the investigation of complaint 56-AS-20230208144257. Refer to LIC809-D for deficiency cited. Violation discovered is listed below:
Staff records did not have CPR/First Aid Training Certification
An exit interview was conducted with and a copy of this report, LIC809-D were provided to caregiver, Henrietta Chavez .
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction