Facility Evaluation Report
Capacity15
Census15
Date signed09/16/2025 03:58:17 PM
Name of licensing program analystAlbert Johnson
Name of licensing program managerLisa Rios
Licensing Program Analyst Albert Johnson arrived to conduct an unannounced case management visit for an incident reported to the department.
LPA conducted a file review for R1 with the assistance of the Administrator. R1's LIC 602 was current. The Department conducted a case management visit to investigate a special incident report received.
The incident report detailed that, R1 was sent out to the ER for generalized weakness and off her baseline. R1 has since returned to the facility with no new orders. R1 requested to be returned back to Shepherd home in lieu of a rehabilitation center.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction