Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management - Incident visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Princess David. LPA also spoke with Administrator Emerita Garcia via phone during the visit.

Today's visit was in response to licensee’s self-reported death of Client #1 (C1), received at the CCLD San Diego Regional Office on 07/11/2023. [See LIC 811 Confidential Names List for a description of C1]. Per the report, C1 passed away on 07/10/2023.

LPA performed a brief facility tour and welfare check on the one (1) remaining client in care, who reported that they were safe and doing well. LPA also reviewed pertinent records and interviewed relevant staff.

No deficiencies were observed or cited during today's visit. However, LPA provided Technical Assistance to Licensee regarding a chirping smoke detector (refer to the LIC 9102-TA form).

An exit interview was conducted with David, to whom a copy of this report, the LIC9102-TA, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.