Senior Care Records.

Facility Evaluation Report

Maryann Patacsil's Care Home #2, Stockton09/13/2021Licence 397005503

Capacity6
Census6
Date signed09/14/2021 05:32:45 PM
The inspector’s account

On 09/14/2021 at 2:58pm, Licensing Program Analyst (LPA) Ashley Boothe spoke with Licensee regarding facility risk assessment questions who confirmed no staff or clients have experienced symptoms within the last 10 days. At 3:05pm, LPA arrived unannounced to conduct a case management visit and explained the purpose of today’s visit. LPA was allowed entry into the facility and met with Designated staff (S1) and Licensee arrived shortly after. Census 6.

On 9/13/2021 LPA received a phone call from Licensee for request of Department approval for 3 day eviction of Resident one (R1). During today's inspection LPA conducted interviews and requested records for the departments review. Previous records were requested on 9/13/2021 via email. The Department will review and provide the Licensee a response as outlined in California Code of Regulations Title 22 85068.5 Eviction Procedures.

LPA encountered computer consistency check and stepped away at 4:30pm and returned at 5:00pm to finalize reports and print documents.

Per the California Code of Regulations, Title 22, Division 6, no deficiencies observed or cited. Exit interview held and a copy of report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction