Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Johnson arrived for the purpose of conducting a POC visit. LPA met with Staff and together conducted a tour of the home.

The following deficiencies, initially cited during a visit on 11/20/2025, have been cleared:

Section Cited: 87355(e)(1) Date Due: 11/21/2025

Plan of Correction: Effective immediately, the Licensee/ Administrator shall ensure that S1 does not work until fingerprint clearance and association is obtained. Licensee/Administrator shall also ensure that S1 obtains fingerprint clearance and association to the facility. Licensee/ Administrator shall send proof of fingerprint clearance and association to CCL

Corrections: Cleared By Visit Clearance Date: 04/22/2026

LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents.