Facility Evaluation Report
Capacity6
Census6
Date signed02/28/2023 03:29:10 PM
Licensing Program Analyst Albert Johnson arrived to conduct an unannounced Case Management visit. LPA met with Staff.
Community Care Licensing received incident reports regarding an AWOL. LPA requested residents files for review. LPA spoke with Administrator regarding the incident reports.
LPA did obtained copies of resident records. R1 is allowed to go into the community without assistance. This is identified in R1's Physician's report. R1 is allowed to go into the community without assistance.
Per California Code of Regulations and Health and Safety Code, Title 22.
Exit interview. Copy of report provided to facility representative.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction