Senior Care Records.

Facility Evaluation Report

Westborough Manor 6, San Bruno11/19/2024Licence 415600848

Capacity6
Census5
Date signed11/19/2024 12:59:37 PM
The inspector’s account

On 11/19/2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced plan of correction visit. LPA met with caregiver, Ferdinand and explained the purpose of today's visit. Caregiver called the co-licensee, Sheila Diaz to inform LPA's visit and LPA explained the purpose of today's visit to the co-licensee over the phone.

On 11/6/2024, facility received a civil penalty for not having a copy of the current General Liability Insurance and the civil penalty was assessed from 10/25/2024- 11/6/2024 in the amount $1200 ($100 per day).

On 11/15/2024, LPA received a copy of the current General Liability Insurance.

During today visit, an additional civil penalty is being assessed from 11/7/2024 - 11/14//2024 in the amount of $800 ($100 per day) and civil penalty has been stopped on 11/15/2024 as the citation has been corrected.

This report is reviewed and discussed in person with the caregiver and on the phone with the co-licensee.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction