Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced case management visit to address the deficiencies observed during a complaint investigation on 07/29/2025. LPA Rai met with Administrator, Fredricka Safar and stated the purpose of today's visit.

During the complaint investigation, LPA Rai did not receive requested documents from resident (R1)'s facility file dated 2018. The complaint was regarding an incident that occurred from 2018. LPA Rai received the Incident Report from 2018, but Administrator Fredricka was not able to provide any documentation of R1 from 2018.

Administrator Fredricka stated they do not keep records over 3 years for any of the residents, including R1.

LPA Rai clarified that the facility needs to retain resident records for at least three years following termination of service to the client.

Deficiencies were cited per California Code of Regulations, Title 22. See LIC 809-D. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Administrator, Fredricka Safar and a copy of the report was provided. Appeal Rights were provided.