Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon conducted a Case Management Visit to do a welfare check on the residents in care. LPA was joined by TCRC QA Miguel Magana. LPA met with the Licensee and explained the purpose of the visit.

The residents were clean and safe on arrival. The facility has food, medications, and all needed supplies for the facility to run properly. Resident 1 (R1's) family was present and had no issues with safety concerns. Licensee is present at the facility and the facility is currently employing 4 staff. Administrator is on leave and Licensee is covering the duties of Administrator at this time. Staff 1 (S1) is currently in process of taking all required courses to become an Administrator. Licensee is going to speak with another Administrator to take on the duties temporarily till the new Administrator is certified.

The facility property is not currently up for sale. The Licensee and POA are not planning to list the facility up for sale at this time. The Licensee has agreed when and if it is decided at a later date to list the property for sale Community Care Licensing (CCL) and Tri-County Regional Center would be notified. The Licensee will work with both agencies and provide a full closure plan with relocation. Licensee agreed the facility will remain open and operating until any placement's are resolved.

LPA requested the following documentation for review: 4 residents LIC 602 Physicians Reports, Appraisal needs and services plan, and Identification and emergency forms. S1 provided most of the forms at the visit and S1 will email LPA the remaining documents requested.

Exit interview conducted and copy of report printed for Licensee.