Facility Evaluation Report

On 03/22/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management deficiencies visit. LPA met with Co Licensee/Administrator - Romar Raquinil and explained the purpose of today's visit.

This visit is a follow up visit in relation to a complaint received on 08/21/2023 complaint #14-AS-20230821165002. Findings to these allegations were delivered on 12/20/2023. An additional citation is issued as a result of the investigation's findings on the following LIC809D page.

The deficiencies for the substantiated allegations are cited in accordance with California Code of Regulations, Title 22, Division 6 and is noted on attached LIC809D. Immediate Civil Penalty of $500 is assessed for a violation resulting in serious bodily injury. The facility was informed that additional civil penalties may be assessed. Report is reviewed with Co Licensee/Administrator - Romar Raquinil and a copy is provided with appeal rights. A copy of the civil penalty will be provided