Facility Evaluation Report

Licensing Program Analyst, David Roman (LPA D. Roman) conducted an unannounced case management inspection to cite deficiencies observed during a complaint visit that are unrelated to the complaint investigation. LPA D. Roman identified himself, was greeted by and explained the purpose of the visit to Administrator, Deborah Alvarado.

During the facility tour of the unrelated complaint visit, LPA D. Roman observed pest spray chemicals on the night stand of a resident's room. LPA D. Roman also observed the outdoor space to have junked hazards (a laundry machine flipped on its side, paint buckets, mop buckets, old medication cart, old furniture such as drawers, chairs, and walkers).

Therefore, two deficiencies are being cited per California Code of Regulations Title 22 and noted on the attached LIC 809-D pages.

An exit interview was conducted with Administrator, Deborah Alvarado, whose signature below confirms receipt of a copy of this report and the Licensee/Appeal Rights.