Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Boyles made an unannounced Case Management visit to the facility in order to review facility records. LPA was welcomed by and discussed the purpose of the visit with Caregiver Melia Ebuen and also spoke to Administrator Myrna Arcelao over the phone.

LP A conducted a brief facility tour and reviewed resident records. A record review and interview with the Administrator confirmed that the facility no longer maintained records for Resident #1 (R1), who no longer resides at the facility. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.]

One citation is being cited per California Code of Regulations, Title 22 (refer to the attached LIC809-D page. A plan of correction was jointly developed with the Administrator. An exit interview was conducted with staff Melia Ebuen to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.