Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an on-site Case Management visit at the facility. LPA Hamilton was greeted at the front door by Licensee, Christina Hernandez and granted entry after identifying herself. LPA explained the purpose of the visit which was to follow-up on the Case Management visit from September 20, 2022.

On September 20, 2022, LPA Hamilton conducted a file review on all clients in care. The facility was missing the client medical assessment information for client 1 (C1 see LIC 811 confidential names list) and incomplete medical assessments for C2 and C3. A deficiency was cited during today’s visit. See LIC 809D page for citation and plan of correction. LPA also advised Licensee of Title 22, Division 6, Chapter 1, Article 6 Continuing Requirements, Section 80068.5 Eviction Notices, 80066 Personnel Records and 80070 Client Records. LPA advised the Licensee how to submit a 30-day Eviction Notices to Community Care Licensing (CCL) for review and what needs to be included in Client and Personnel Records. Technical Advisories given.

An exit interview was conducted with Licensee and a copy of this report, LIC 809D, LIC 81, LIC 9102 and Licensee/Appeal Rights (LIC9058 01/16) were provided.