Facility Evaluation Report

Licensing Program Analyst (LPA), Tiffany Holmes conducted an unannounced case management visit. LPA Holmes introduced herself and was allowed entry into the facility and explained the purpose of the visit to Administrator Shanta Haines.

Today’s visit was regarding the alterations being done on the facility. The facility did not provide any notice to CCL regarding the construction of the new office and client room. LPA Holmes requested copies of the building permit for the facility construction.

Based on today's inspection, deficiencies were observed.

The violation is cited in accordance with California Code of Regulations, Title 22, and is recorded on the attached 809-D (Deficiency) Page.

An exit interview was conducted with Shanta Haines Administrator. A copy of this report, and the Licensee/Appeal Rights (9058 01/16) were provided via e-mail. An electronic read receipt verifies receipt of these documents.