Facility Evaluation Report

Licensing Program Analysts LPA Marcela Yanez conducted an unannounced visit to conduct an investigation visit for a complaint received on 03/28/2025. During the complaint investigation, a case management was conducted due to deficiencies observed during the investigation process. LPA met with Lead Staff Tess Marites Fernandez

During the visit LPA observed the facility van had been in an accident and had damages to the front of the right side front bumper (photographs taken)

Lead Staff was interviewed and stated that the facility van had been in an accident approximately occurred between 03/20/25 and 03/21/25 and was instructed by Administrator to do a body check on the residents who were in the van when accident occurred. According to S1 residents in the van did not sustain any injuries in the accident. ADM did not report the accident to the department within 7 days of incident.

During todays visit LPA contacted LPM Manzano to call the ADM to meet LPA at the facility but there was no response by ADM and did not show up at the facility.

S1 stated that the ADM has 4 other facilities and including this facility and a day program (Unknown name)

ADM will provide LIC 500 of her work schedule and all licensed facility to the department that she/he operates

LPA informed S1 that Administrator to spend at least 20 hours a week Monday thru Friday 8-5 PM