Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to cite a deficiency identified during a separate complaint investigation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Executive Director Calais Anguiano.

Former Resident #1 (R1) and their representative/responsible person (RP) signed the Admissions Agreement contract which Licensee prepared and presented to them. [See LIC811 Confidential Names List for a description of R1.] However, a facility representative did not co-sign this contract on behalf of Licensee, even after seven (7) days after move-in.

One (1) deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with the Licensee.

An exit interview was conducted with Anguiano, to whom a copy of this report, the LIC 809-D, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.